To evaluate the preferred eyelid height and laterality according to differences in marginal reflex distance 1 (MRD1) in Korean patients with an ocular prosthesis.

A study of 46 eyes was conducted for patients with an ocular prosthesis between August 2016 and March 2018. In a slide show with the original and mirror-reversed photographs and upper eyelid height 1 mm above and below the base level, patients were asked which of the photographs of themselves they preferred.

Patients divided evenly into 23 individuals with a right side ocular prosthesis and 23 individuals with a left side ocular prosthesis. Among the patients, 47.8% preferred the mirror-reversed photograph and 52.2% preferred the original photograph. Meanwhile, 67.4% with the left side ocular prosthesis preferred the original photograph and 32.6% with the right side ocular prosthesis preferred the original photograph ( p = 0.02). Additionally, 69.3% preferred their upper eyelid height 1 mm above the original photograph, 21.7% preferred their upper eyelid height 1 mm below the original photograph, and 13.0% preferred the level of the original photograph ( p < 0.01). Twenty-five patients had < 1 mm difference of MRD1 (group A). Sixteen patients had 1 mm smaller MRD1 with an ocular prosthesis than with a normal eye (group B). Five patients had 1 mm larger MRD1 with an ocular prosthesis than with a normal eye (group C). Group A and B patients preferred the photograph with their upper eyelid 1 mm above from the original photograph ( p < 0.01).

Patients with an ocular prosthesis significantly preferred the photograph of their upper eyelid height 1 mm above the base level when the height of the ocular prosthesis was smaller or similar to the normal eye. And patients preferred the photographs with left sided prosthesis regardless of their original direction.