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Childhood ptosis
Pediatric Ophthalmology
Key Points
- •Congenital ptosis accounts for >90% of childhood ptosis; caused by LPS muscle dysgenesis (fibro-fatty replacement) - key sign is lid lag on downgaze
- •15–20% of congenital ptosis patients develop amblyopia (deprivation, astigmatism, or associated strabismus) - visual assessment is CRITICAL
- •Surgical choice depends on LPS function: good (>8 mm) → LPS resection; poor (<4 mm) → frontalis sling (autogenous fascia lata is gold standard)
- •Marcus Gunn jaw-winking (2–13% of congenital ptosis) requires bilateral LPS disinsertion + bilateral frontalis sling for severe cases
- •Congenital Horner syndrome (mild ptosis + miosis + iris heterochromia) → mandatory urine VMA/HVA to exclude neuroblastoma
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Keep reading Childhood ptosis
17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations