Rucker Janet C
Departments of Neurology and Ophthalmology, The Mount Sinai Medical Center, New York, NY 10029, USA.
Handb Clin Neurol. 2011;102:403-24. doi: 10.1016/B978-0-444-52903-9.00021-2.
This chapter on lid function is comprised of two primary sections, the first on normal eyelid anatomy, neurological innervation, and physiology, and the second on abnormal eyelid function in disease states. The eyelids serve several important ocular functions, the primary objectives of which are protection of the anterior globe from injury and maintenance of the ocular tear film. Typical eyelid behaviors to perform these functions include blinking (voluntary, spontaneous, or reflexive), voluntary eye closure (gentle or forced), partial lid lowering during squinting, normal lid retraction during emotional states such as surprise or fear (startle reflex), and coordination of lid movements with vertical eye movements for maximal eye protection. Detailed description of the neurological innervation patterns and neurophysiology of each of these lid behaviors is provided. Abnormal lid function is divided by conditions resulting in excessive lid closure (cerebral ptosis, apraxia of lid opening, blepharospasm, oculomotor palsy, Horner's syndrome, myasthenia gravis, and mechanical) and those resulting in excessive lid opening (midbrain lid retraction, facial nerve palsy, and lid retraction due to orbital disease).
本章关于眼睑功能主要由两个部分组成，第一部分是正常眼睑的解剖结构、神经支配和生理学，第二部分是疾病状态下的异常眼睑功能。眼睑具有多种重要的眼部功能，其主要目的是保护眼球前部免受损伤并维持眼表泪膜。执行这些功能的典型眼睑行为包括眨眼（自主、自发或反射性）、自主闭眼（轻柔或用力）、斜视时部分眼睑下垂、在惊讶或恐惧等情绪状态下正常的眼睑退缩（惊吓反射），以及眼睑运动与眼球垂直运动的协调以实现最大程度的眼部保护。文中提供了对这些眼睑行为的神经支配模式和神经生理学的详细描述。异常眼睑功能按导致眼睑过度闭合的情况（大脑性上睑下垂、眼睑开合失用症、眼睑痉挛、动眼神经麻痹、霍纳综合征、重症肌无力和机械性原因）以及导致眼睑过度张开的情况（中脑性眼睑退缩、面神经麻痹和眼眶疾病导致的眼睑退缩）进行划分。
