Abstract
Blepharoptosis is present when the upper eyelid is lower than its normal anatomic position in primary gaze. This is secondary to a neuromuscular imbalance with weakening of the upper eyelid retractors in relation to the protractors. As the degree of ptosis worsens, significant functional and cosmetic concerns often arise. To adequately address these concerns, ptosis is divided into categories based on the underlying pathogenesis: aponeurotic, myogenic, neurogenic, mechanical, or traumatic. Within these categories, it is important to determine if the ptosis is congenital or acquired as diagnostic and therapeutic approaches often vary between these two distinctions. The goal of this review is to summarize the classification, evaluation, management, and potential pitfalls of both acquired and congenital ptosis.
Highlights
Blepharoptosis, commonly referred to as ptosis, is present when the upper eyelid is lower than its normal anatomic position in primary gaze
The goal of this review is to summarize the classification, evaluation, management, and potential pitfalls of both acquired and congenital ptosis
Cosmetic complaints often focus on achieving facial symmetry as the perception of ptosis severity can be exacerbated by asymmetric eyelid features
Summary
Blepharoptosis, commonly referred to as ptosis, is present when the upper eyelid is lower than its normal anatomic position in primary gaze. The term is derived from the Greek expression blepharon “eyelid” and ptōsis “act of falling”[1,2]. The average adult upper eyelid margin rests 0.5-2 mm below the superior corneal limbus with ptosis being classified as mild (1-2 mm), moderate (3-4 mm), or severe (> 4 mm)[3]. As the degree of ptosis worsens, significant functional and cosmetic concerns often arise. The goal of this review is to summarize the classification, evaluation, management, and potential pitfalls of both acquired and congenital ptosis
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