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Chapter-51 Congenital Ptosis: Evaluation and Surgical Management

BOOK TITLE: Surgical Techniques in Ophthalmology (Pediatric Ophthalmic Surgery)

Author
1. Grover AK
2. Bageja Shaloo
ISBN
9789350251485
DOI
10.5005/jp/books/11282_51
Edition
1/e
Publishing Year
2011
Pages
24
Author Affiliations
1. Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, Sir Ganga Ram Hospital, New Delhi; Vision Eye Centre, New Delhi, India, Sir Ganga Ram Hospital and Vision Eye Center, New Delhi, India, Sir Ganga Ram Hospital; Vision Eye Center, New Delhi, India, Sir Gangaram Hospital, Rajender Nagar, New Delhi, India, Sir Gangaram Hospital, New Delhi, Sir Ganga Ram Hospital, New Delhi, India, Sir Ganga Ram Hospital, Director, Vision Eye Clinic, 12/27, West Patel Nagar, Near Arya Samaj Mandir, New Delhi, India, Sir Ganga Ram Hospital, Rajender Nagar, New Delhi, India, Ganga Ram Hospital, New Delhi, India, Sir Ganga Ram Hospital, Rajinder nagar, New Delhi, India, Department of Ophthalmology, Sir Gangaram Hospital, Rajinder Nagar, New Delhi, India
2. Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India, Sir Ganga Ram Hospital, Rajender Nagar, New Delhi, India, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi (India), Vision Eye Clinic, 12/27, West Patel Nagar, Near Arya Samaj Mandir, New Delhi, India, Sir Gangaram Hospital, Rajender Nagar, New Delhi, India, Sir Ganga Ram Hospital, New Delhi, India
Chapter keywords

Abstract

Congenital ptosis is a common entity which results from a developmental dystrophy of the levator muscle of unknown etiology. Congenital ptosis may be classified as congenital simple ptosis, complicated, with oculomotor abnormalities, with blepharophimosis syndrome, synkinetic ptosis, Marcus Gunn Jaw Winking, misdirected third nerve ptosis. Preoperative history and examination are vital because these decide the choice of surgery. It is important to determine whether the condition is congenital or acquired. Ocular examination is important part of the assessment. Surgical approach depends upon whether the ptosis is unilateral or bilateral, severity of ptosis, levator action. Commonly performed surgeries are Fasanella Servat Operation, levator resection, Brow suspension ptosis repair. Complications occur the common ones are under correction, overcorrection, lid lag, notching of the lid margin, exposure keratitis. Though the sling surgery is much simpler than levator surgery, yet it is accompanied by some complications. Management of complicated ptosis is different from the ordinary ptosis. The complicated ptosis types are congenital ptosis with superior rectus weakness, ptosis associated with double elevator palsy and ptosis with oculomotor abnormalities.

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