Which finding from an examination of the external eye, eyelids, and lacrimal apparatus is normal?
a. an area of white sclera appears between the upper lid and limbus
b. the eyelids cover the upper portion of the iris
c. both lower eyelids turn outward
d. redness is present in the temporal portion of both eyelids
B
The examination of the external eye includes the eyelids and the lacrimal apparatus. The eyelids should appear symmetrical with no drooping, infections, or tumors of the lids. When the eyes are focused in a normal frontal gaze, the lids should cover the upper portion of the iris. The patient should be able to raise both eyelids symmetrically (CN III). Slight ptosis or drooping of the lid can be normal. When the eye is closed, no portion of the sclera should be exposed. Normal lid margins are smooth with the lashes evenly distributed and sweeping upward from the upper lids and downward from the lower lids. It is abnormal for an area of white sclera to appear between the upper lid and the limbus (lid lag). It is abnormal for the lower lids to turn outward (ectropion). It is abnormal for redness to be present in the temporal portion of one or both eyelid(s).
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