Marginreflex distance MRD

Since palpebral aperture is not only affected by the degree of ptosis but also by the lower lid position (Figure 5.1b), it is sometimes more useful to get the patient to fixate a point light source in the primary position and to measure the distance from the corneal light

Figure 5.1 Palpebral aperture measurement.

(a) Vertical measurement.

(b) Same vertical measurement with left ptosis compensated by left lower lid retraction.

(c) Margin reflex distance measurement.

Figure 5.1 Palpebral aperture measurement.

(a) Vertical measurement.

(b) Same vertical measurement with left ptosis compensated by left lower lid retraction.

(c) Margin reflex distance measurement.

reflex to the upper lid margin (MRD1) and from the reflex to the lower lid margin (MRD2) (Figure 5.1c).

The two numbers are recorded thus

The upper lid may obscure the visual axis in which case MRD 1 is recorded as a negative number.

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