Prevalence of visual function impairment in congenital ptosis
Reviewed by Fiona Rowe

This study sought to evaluate the prevalence of visual function loss in the setting of congenital ptosis. This was a retrospective study of 155 eyes of 134 patients; 72 males and 62 females. Mean age at diagnosis was 7.8 ±5.8 years with mean follow-up of 8.5 ±6 years. Ptosis was right in 53 eyes, left in 44 and bilateral in 26; mild in 11, moderate in 49 and severe in 63 eyes. All underwent surgery and nocturnal lagopthalmos was the only complication in 16 eyes which resolved in all but two eyes within three months. Dystrophic congenital ptosis was diagnosed in 98, Marcus Gunn in nine, blepherophimosis syndrome in 10, double elevator syndrome in two, congenital fibrosis of the extraocular muscle (CFEOM) in four and Mobius syndrome on one. The mean final visual acuity was 0.11 ±0.23 logMAR. Thirty developed amblyopia and five had visual loss due to structural eye pathology. Deprivation amblyopia accounted for 25 cases. Risk factors associated with final visual acuity were presence of amblyopia, anisometropia and ptosis severity. The authors report a prevalence of ptosis of 8.1% in this study. They conclude the higher rate may represent their tertiary referral centre recruitment. Prevalence of ocular pathology with ptosis was 5% with visual function loss in 28.5% and persistent visual impairment in 11%. They recommend those with severe ptosis and poor visual function at presentation may benefit from a more aggressive treatment regime.

Evaluation of all causes of visual function loss in children with congenital blepharoptosis.
Ural O, Mocan MC, Erdener U.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2020;57:97-102.