Objective:

To highlight the importance of upper lid eversion in ocular examinations for diagnosing ocular and systemic conditions, ultimately improving patient outcomes.

Approach:

Key Findings:

• Failure to examine the upper lid can lead to missed diagnoses of ocular and systemic conditions, including those related to systemic diseases like Sjögren syndrome.
• Upper lid eversion helps identify meibomian gland dysfunction (MGD) and lid wiper epitheliopathy (LWE), which are critical for managing dry eye symptoms.
• Conditions like giant papillary conjunctivitis can be detected through upper lid examination, especially in contact lens wearers.

Interpretation:

Routine upper lid eversion is essential for a thorough ocular surface examination and can significantly impact patient management and outcomes by allowing for early detection of conditions.

Limitations:

• Underutilization of upper lid eversion may lead to missed diagnoses, particularly in patients with systemic conditions.
• Not all clinicians may be trained or familiar with the technique, which can hinder its implementation in practice.

Conclusion:

Incorporating upper lid eversion into standard ocular examinations can enhance the detection of various ocular conditions, improving patient care and emphasizing the need for clinician education on this technique.

Sources:

• Comprehensive assessment of the meibomian glands
Source

Based on findings from:

Everting the Upper Lid

Mile Brujic, OD, FAAO. Optometric Management, 2026.

https://www.optometricmanagement.com/issues/2026/january-february/everting-the-upper-lid

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