Eyelid retraction treated by levator marginal myotomy.

Upper eyelid retraction in patients with ophthalmic Graves' disease may be due to: (1) overaction of Müller's muscle; (2) overaction of the levator muscle; (3) contraction of the levator; and (4) subcutaneous adhesions anterior to the levator. A new operation is described to lengthen the levator by performing partial width (marginal) myotomies. If present, subcutaneous adhesions can also be divided during this operation. Histologic features of levators and Müller's muscles from patients with upper eyelid retraction are discussed.