Background: Knowledge of the average dimensions of periocular features based on age, gender, and race is critical for surgeons so that complications can be avoided and ideal outcomes can be achieved. In this study, the authors sought to determine whether significant differences exist for certain eyelid and eyebrow dimensions between African American and white adults.
Methods: Both eyes of 89 African American and 75 white subjects, aged 20 to 80 years, were evaluated. Subjects were divided by gender into three, 20-year age cohorts. Measurements of palpebral fissure height, palpebral fissure width, palpebral fissure inclination, pretarsal skin height, crease height, eyebrow height, eyebrow apex angle, and distance of the brow apex from the lateral corneal limbus were taken from standardized photographs. Mean values by race, age, and gender were compared using linear mixed modeling. Double-lid crease prevalence was also evaluated.
Results: A significant difference was found between races for palpebral fissure width, pretarsal skin height, and crease height in men, and for eyebrow height in both men and women. A significant difference between genders was found for palpebral fissure height, palpebral fissure width, pretarsal skin height, and crease height in whites; for palpebral fissure inclination, eyebrow height, and distance of the brow apex from the lateral corneal limbus in both whites and blacks; and for eyebrow apex angle in blacks. Significant differences were also found between age cohorts for palpebral fissure height in black women and for eyebrow height in black men. Thirty-seven percent of African Americans had a double-lid crease versus 15 percent of whites.
Conclusions: Race, gender, and age differences exist for certain eyelid and eyebrow positions. These factors can impact surgical decision-making and thus highlight the need for an individualized approach to patients.