Novel Device and Methodology of Measuring Eyelid Skin in Oculoplastics

Superotemporal visual field obstruction (VFO) often comes from a mix of dermatochalasis, brow ptosis, and blepharoptosis. Although the HFA is commonly used to assess this, it’s not always available, and there’s no straightforward physical examination tool that gives a quick, objective measurement of upper eyelid redundancy, especially in clinics outside ophthalmology. The authors designed a simple, caliper-like device to fill this gap. The device uses curved blades shaped to fit natural eyelid contour, with 1 mm markings that allow for consistent measurements across the upper lid. It can be used for static assessments or before and after a brow lift maneuver to document change. The authors tested the device on 2 patients with moderate to severe dermatochalasis. Measurements were quick, well-tolerated, and showed clear differences in skin redundancy. Because of the novelty of this device and method, it has been designated as the Choi Lid Index Gauge (CLIG). CLIG offers a low-cost, reproducible way to quantify upper eyelid skin excess. It could help surgeons objectively document surgical need, plan laterality, and track pre-op and post-op changes, especially in patients where the line between functional and aesthetic indication matters. With further validation, it may also support insurance documentation and reduce reliance on HFA in certain clinical settings.