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PURPOSE: To evaluate whether the flashlight feature of smartphones can be used to replace the traditional flashlight for measuring MRD and investigate the relation between increasing light intensities and MRD measurements. METHODS: A prospective clinical study was conducted with 40 individuals from Hospital de Clínicas de Porto Alegre. Outcome measures: MRD1, MRD2, and palpebral fissure height (PFH) were analyzed by photographic record using different intensity light sources. RESULTS: Flashlight (10 lux): MRD1 mean: 3.97 mm ±1.16; PFH mean: 9.87 mm ±1.53; Smartphone (100 lux) MRD1 mean: 4.02 mm ±1.17; and PFH mean: 9.62 mm ± 1.45 (p > .05). Using a dimmable source of light resulted in a mean reduction of the PFH of 0.75 mm with the highest light intensity (1200 lux). There was no statistically significant association between MRD changes and the iris color, age, and gender of the subjects. CONCLUSIONS: There was no statistically significant difference between the MRD measurements using traditional flashlights compared to higher intensity smartphone flashlight. Using a dimmable source of light, there is a statistically significant reduction in palpebral fissure with higher light intensity, which occurs mostly by upper eyelid lowering, probably due to orbicularis oculi muscle contraction. A smartphone with a built-in flashlight can be used to replace the traditional flashlight in clinical practice without prejudice to the evaluation of the MRD.

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PURPOSE: To investigate differences in the palpebral fissure eyelid position in Japanese subjects and in Brazilian subjects of European descent over 50 years of age. METHODS: A cross-sectional study evaluating 50 Japanese subjects and 50 Bra---zilian subjects of European descent over 50 years of age was performed to evaluate the effect of aging on eyelid position. Digital photographs were taken with the eyes in the primary position and transferred to a computer to be processed by Scion imaging software for evaluation of palpebral fissure width, height, and margin reflex distance (MRD). The data were statistically analyzed according to sex, age, and race. RESULTS: The width of the eyelid fissure in Japanese subjects was higher than that in Brazilian subjects, whereas the height of the eyelid fissure and the MRD1 was higher in Brazilians than in Japanese (p<0.01). Width, height, and MRD1 were linearly associated with age only in the Japanese group (p<0.05); this association was observed only with width in the Brazilian group (p<0.05). There were no differences according to laterality in either group (p>0.05). CONCLUSION: There are racial differences in age-related changes in the eyelids, which are more marked in Japanese subjects.

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ABSTRACT Purpose: To investigate differences in the palpebral fissure eyelid position in Japanese subjects and in Brazilian subjects of European descent over 50 years of age. Methods: A cross-sectional study evaluating 50 Japanese subjects and 50 Bra­­­zilian subjects of European descent over 50 years of age was performed to evaluate the effect of aging on eyelid position. Digital photographs were taken with the eyes in the primary position and transferred to a computer to be processed by Scion imaging software for evaluation of palpebral fissure width, height, and margin reflex distance (MRD). The data were statistically analyzed according to sex, age, and race. Results: The width of the eyelid fissure in Japanese subjects was higher than that in Brazilian subjects, whereas the height of the eyelid fissure and the MRD1 was higher in Brazilians than in Japanese (p<0.01). Width, height, and MRD1 were linearly associated with age only in the Japanese group (p<0.05); this association was observed only with width in the Brazilian group (p<0.05). There were no differences according to laterality in either group (p>0.05). Conclusion: There are racial differences in age-related changes in the eyelids, which are more marked in Japanese subjects.

RESUMO Objetivo: Investigar as diferenças no posicionamento da fenda palpebral em ja­po­neses e brasileiros de descendência européia maiores de 50 anos. Métodos: Estudo transversal avaliando-se 50 japoneses e 50 brasileiros de descendência européia maiores que 50 anos de idade, avaliando-se o efeito do envelhe­cimento sobre a posição palpebral. As fotografias digitais foram realizadas em posição primária do olhar e transferidas para um computador para serem processadas pelo software de imagem Scion, avaliando-se as medidas da altura e comprimento da fenda palpebral e distância margem-reflexo (MRD). Os dados foram analisados pela estatística segundo sexo, idade e raça. Resultados: O comprimento da fenda palpebral em japoneses foi maior do que o dos brasileiros, enquanto que a altura da fenda palpebral e MRD foram maiores nos brasileiros (p<0,01). O comprimento, altura e MRD foram associados à idade li­nearmente apenas em japoneses (p<0,05) e esta associação foi observada apenas quanto ao comprimento no grupo dos brasileiros (p<0,05). Não houve diferença quanto à lateralidade em ambos os grupos (p>0,05). Conclusão: Existem mudanças distintas no processo de envelhecimento palpebral de acordo com a etnia, que parecem ser mais intensas em pálpebras de japoneses.

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METHODS: Ten PD patients in stages 1 and 2 of the Hoehn & Yahr classification were compared to 18 healthy controls. Artifact-free EEG segments of two seconds preceding the onset of the blink potential were averaged and analyzed, and the statistical significance of the measured amplitudes were evaluated by analysis of variance models. RESULTS: The presence of a BP in the PD patients was demonstrated. The mean amplitudes at 0 ms were respectively 0.6 µV and 3.3 µV for the BP patients and the normal controls, respectively. CONCLUSIONS: The BP amplitudes were significantly smaller in PD patients than normal participants. The amplitudes of the BP were not modified by levodopa.

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ABSTRACT The Bereitschaftspotential (BP) is a negative wave observed in EEG retrograde averaging, preceding a motor act. The objective was to study the BP preceding voluntary eyelid blinks in Parkinson's disease (PD) patients during off and on phases of levodopa. Methods Ten PD patients in stages 1 and 2 of the Hoehn & Yahr classification were compared to 18 healthy controls. Artifact-free EEG segments of two seconds preceding the onset of the blink potential were averaged and analyzed, and the statistical significance of the measured amplitudes were evaluated by analysis of variance models. Results The presence of a BP in the PD patients was demonstrated. The mean amplitudes at 0 ms were respectively 0.6 µV and 3.3 µV for the BP patients and the normal controls, respectively. Conclusions The BP amplitudes were significantly smaller in PD patients than normal participants. The amplitudes of the BP were not modified by levodopa.

RESUMO O Potencial de Bereitschafts (PB) é uma onda negativa observada retrogradamente no EEG precedendo um ato motor. Objetivo Estudar o PB precedendo o piscamento palpebral voluntário em pacientes com doença de Parkinson (DP) durante as fases off e on da levodopa. Foram comparados dez pacientes com DP nos estágios 1 e 2 de Hoehn & Yahr com 18 controles saudáveis. Os segmentos de EEG livres de artefatos 2 segundos antes do início do potencial foram calculados e analisados e a significância estatística das amplitudes foi medida por modelos de análise de variância. Resultados A presença de PB nos pacientes com DP foi demonstrada. As amplitudes médias a 0 ms foram respectivamente 0,6 μV e 3,3 μV para os pacientes com DP e controles respectivamente. Conclusões As amplitudes do PB foram significativamente menores nos pacientes com DP do que controles. As amplitudes do PB não foram modificadas pela levodopa.

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PURPOSE: To validate and to report the results of a new inexpensive video-based method to measure upper eyelid motion during spontaneous blinks. METHODS: Spontaneous blinks were simultaneously recorded in 21 healthy adult subjects for 5 minutes with magnetic search coil (MSC) and a portable video system (VDS) composed by a commercial high-speed camera coupled to a laptop computer and a blue light-emitting diode. Agreement between the 2 methods was assessed using qualitative comparison of the eyelid motion traces and Bland-Altman plots. RESULTS: The blink traces registered with both methods were virtually identical. With the either method, the relationship between amplitude and maximum velocity was well fitted by linear regression with mean r values = 0.81 (MSC) and 0.85 (VDS). Bland-Altman plots showed good agreement between methods. The mean ± SE differences of amplitude (0.06 ± 0.17 mm) and maximum velocity (5.0 ± 3.4 mm/s) were not significant. With the VDS, it was also possible to quantify the horizontal component of the blink movements. The amplitude of the horizontal shift of the eyelid during blinks was 40% of the vertical downward phase of the movement. CONCLUSIONS: Blinking kinematics can be precisely measured using a simple and inexpensive video system suitable for clinical settings.

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The anatomy and development of the eyelids in squamate reptiles are still relatively unknown, considering its variation within the group. The neotropical Gymnophthalmini are traditionally characterized by having lost the eyelids, but their structure is not well described. In this study, the embryonic development and the adult morphology of the gymnophthalmid eye, with special attention to the eyelids, the nictitating membrane, and the spectacle are described. The eye in some Gymnophthalmini is covered by a spectacle, formed by the embryonic fusion of the dorsal and ventral eyelids, a character possibly synapomorphic to the tribe. The genus Tretioscincus, which floats either as sister to all other Gymnophthalmini, or is nested within the group, is unique in showing functional and movable eyelids. Thus, the presence of functional eyelids can be either considered as the primitive condition for the gymnophthalmini or as a re-acquisition of the character, showing the importance of a well-established phylogenetic hypothesis for understanding morphological evolution.

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The quantification of differences in alpha electroencephalograph (EEG) activity between the eyes-closed and eyes-open resting conditions could be used as a measure of resting state arousal. The objective of this study was to evaluate the contribution of EEG alpha reactivity on opening the eyes, to the neurophysiology of children with attention-deficit hyperactivity disorder (ADHD). Thirty-eight children with ADHD were assessed using quantitative EEG (qEEG) analysis of absolute band power at rest, with eyes open and closed. Alpha reactivity index was calculated on opening the eyes, defined from the relationship between the absolute powers in the respective bands in the periods with the eyes open and closed. EEG data of 38 sex- and age-matched controls, with no neurological or psychiatric problems, were collected for comparison. There was a significant reduction in absolute alpha power at all electrodes for both ADHD and control groups with eyes open, indicating an increase in the arousal level. However, the alpha reactivity index was greater, corresponding to less reactivity, in the frontal regions of the children with ADHD (P < .01). Such a finding suggests alterations in arousal mechanisms in ADHD. This research suggests that alpha reactivity on opening the eyes, allied with other variables from the qEEG, may improve diagnostic accuracy in ADHD.

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Spontaneous blinking is essential for maintaining a healthy ocular surface and clarity of vision. The spontaneous blink rate (SBR) is believed to reflect a complex interaction between peripheral influences mediated by the eye surface and the central dopaminergic activity. The SBR is thus extremely variable and dependent on a variety of psychological and medical conditions. Many different methods have been employed to measure the SBR and the upper eyelid kinematics during a blink movement. Each has its own merits and drawbacks, and the choice of a specific method should be tailored to the specific needs of the investigation. Although the sequence of muscle events that leads to a blink has been fully described, knowledge about the neural control of spontaneous blinking activity is not complete. The tear film is dynamically modified between blinks, and abnormalities of the blink rate have an obvious influence on the ocular surface.

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INTRODUCTION AND HYPOTHESIS: To determine if Paula method of circular muscles contraction e.g., those surrounding the eyes, mouth and fingers, could increase pelvic floor muscle (PFM) activity. METHODS: Thirty-four healthy, nulliparous volunteers were included, with an average age of 28 (± 5.9) years and body mass index of 23.8 (± 3.3) kg/m(2). They were assigned to randomly perform the sequence: a PFM maximal voluntary contraction, a contraction of circular muscles, followed by a simultaneous combination of PFM and circular muscle contraction. The PFM were evaluated using surface electromyography. RESULTS: PFM activity at baseline was 22.6 (± 10.9) µv. It was unchanged with Paula method contraction (p=0.322). There were also no differences between values of PFM maximal voluntary contraction alone, 99.8 (± 44.3) µv and in combination with the Paula method, 91.8 (± 35.3) µv (p=0.093). CONCLUSIONS: The Paula method seems not to increase PFM activity in nulliparous women.

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