Recognizing the differences in Asian eyelid anatomy

The anatomy of the upper eyelids in patients of Asian descent may be different in several aspects compared to Caucasian eyelids, including eyelid crease shape and height, structure of the medial canthus and tarsus, and fat. Approximately 50 % of the Asian population do not have an upper eyelid crease, which is often referred to as the "single eyelid." Patients with these single eyelids are usually perceived as having narrower palpebral fissures. Patients may complain of having smaller eyes or appearing tired or sleepy. In Asian eyelids in which the lid crease is present, the crease is typically located lower than in the Caucasian eyelid. The crease may be continuous, discontinuous, incomplete, or multiple and should be carefully noted on preoperative evaluation.