Eyelid Eversion Techniques and Clinical Applications

Preparation and Procedure

• Position the patient comfortably with adequate lighting for visualization, as recommended by the American Academy of Ophthalmology 1

Clinical Context for Eyelid Eversion

• The American Academy of Dermatology recommends daily examination during the acute phase of Stevens-Johnson syndrome/toxic epidermal necrolysis to assess tarsal conjunctiva for inflammation, fibrosis, and signs of allergy 2
• The American Academy of Ophthalmology suggests routine dry eye evaluation to document tarsal conjunctival status including inflammation, papillary reaction, follicle enlargement, keratinization, subepithelial fibrosis, and scarring 1
• The American Academy of Ophthalmology recommends blepharitis assessment to evaluate posterior eyelid margin abnormalities and meibomian gland dysfunction 1

What to Examine After Eversion

• Assess the integrity of the tarsal conjunctiva using topical fluorescein to stain epithelial loss, as recommended by the British Association of Dermatologists 2
• Evaluate for mucous threads, scarring, erythema, papillary reaction, follicle enlargement, keratinization, subepithelial fibrosis, foreshortening, and symblepharon, as suggested by the American Academy of Ophthalmology 1

Important Caveats

• Avoid aggressive manipulation in patients with neurotrophic corneas to prevent corneal epithelial injury, as recommended by the American Academy of Ophthalmology, with a strength of evidence level not specified 4