A transverse ligament located anterosuperiorly in the lower orbital fat space restricts lower eyelid retraction in the Mongoloid eye

SummaryWe previously reported that a lower positioned transverse ligament, which was identified just above the fusional line between the orbital septum and the levator aponeurosis or anteroinferiorly in the upper orbital fat space, determines the lower position of the preaponeurotic fat, and restricts the upper eyelid retraction causing the external features that define the appearance of the Mongoloid eye. Because the narrow palpebral fissure of the Mongoloid eye is composed of the restricted upper eyelid and the restricted lower eyelid, we surmised that the ligamentous tissue, which is analogous to the lower positioned transverse ligament in the upper eyelid, might also exist in the lower eyelid.