Researchers in the UK have determined that using a silicone finger-shaped substitute for upper eyelid eversion is more comfortable for the patient, quicker to perform and exposes a greater area of tarsal plate compared with other eversion tools.

The study examined different possible lid eversion tools on 25 participants: a cotton wool bud, the wooden end of a bud, a practitioner’s finger or finger-shaped silicone substitute. They also evaluated the tool’s placement on the extended upper eyelid either centrally, at the top of the tarsal plate or off-center. They measured which tool and technique combination was the most comfortable for the patient, quickest to perform and exposed the largest area of palpebral conjunctiva.

The most comfortable techniques were using the practitioner’s fingers or the silicone everter. Placing the everter at the top of the tarsal plate allowed more area of the palpebral conjunctiva to be exposed and was quicker to perform than central placement of the everter. Off-center placement was less comfortable, took longer and exposed the least area of the palpebral conjunctiva, so careful placement of the everter is required for effective results.

Researchers also emphasized that cotton debris can become detached when using a cotton wool bud—a problem solved by using a reusable and easily sterilized silicone everter. The tool also reduces the waste created from single-use cotton buds.

Wolfsfsohn JS, Tahlan M, Vidal-Rohr M, et al. Best technique for upper lid eversion.  Cont Lens Anterior Eye. July 18, 2019. [Epub ahead of print].