Lid eversion involves flipping the eyelid to examine the underside for foreign bodies or other abnormalities. Here's how to perform it:
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Patient Preparation: Have the patient look down. This relaxes the levator palpebrae superioris muscle, making the procedure easier and more comfortable.
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Positioning: Gently grasp the eyelashes of the upper eyelid between your thumb and index finger.
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Application of the Cotton Tip: Place a cotton tip applicator horizontally on the upper eyelid, just above the tarsal plate (approximately 1 cm above the lid margin).
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Eversion Technique: While the patient continues to look down, pull the eyelashes gently downwards and outwards. Simultaneously, use the cotton tip applicator as a fulcrum to flip the eyelid upwards over the applicator. Think of bringing the edge of the eyelid up and over the applicator as you pull down.
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Securing the Everted Lid (if needed): Once everted, the lid usually stays in place on its own. If not, maintain gentle pressure with the cotton tip applicator against the everted lid. You can also use your fingers.
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Examination: Examine the palpebral conjunctiva for any foreign bodies, inflammation, or other abnormalities.
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Returning the Lid to Normal Position: To return the lid to its normal position, ask the patient to look upwards. Gently pull the eyelashes downwards, and the lid should flip back into place.
