Strabismus in Childhood Eyelid Ptosis

Abstract

Purpose To report the prevalence and causes of strabismus among children with eyelid ptosis diagnosed in a well-defined population over a 40-year period. Design Retrospective, population-based cohort study. Methods We retrospectively reviewed the charts of one hundred and seven patients (< 19 years) for the prevalence and causes of strabismus who were diagnosed with childhood eyelid ptosis as residents of Olmsted County, Minnesota, from January 1, 1965, through December 31, 2004. Results Strabismus was diagnosed in 20 (18.7%) of the 107 patients with childhood ptosis. Eight (9.9%) of the 81 patients diagnosed with simple congenital ptosis had strabismus, of which there were 4 (4.9%) cases of exotropia and 4 (4.9%) cases of esotropia. There were no cases of isolated vertical deviation. Conclusions Strabismus occurred in 1 in 5 children diagnosed with any form of childhood ptosis in this population-based cohort. Strabismus affected approximately 1 in 10 patients diagnosed with simple congenital ptosis, with a predominance of isolated horizontal deviations equally divided between esotropia and exotropia.

Posttraumatic Subperiosteal Orbital Hematoma With Intracranial Hemorrhage in A Male Infant

“…Both blepharoptosis and conjunctival prolapse interfere with the pupillary axis, resulting in deprivation amblyopia in children under seven years of age [9]. Especially, physicians must consider this complication in all children under two years of age.…”

“…The incidence of strabismus in simple congenital ptosis is approximately 9.9% and is higher compared to its incidence in the general population (1% to 5%) [9]. It is suggested that strabismus results from visual occlusion and disruption of binocularity by the ptotic eyelid [9]. Therefore, careful examinations are essential in patients presenting with ptosis after trauma.…”

Advances in the Genetics of Congenital Ptosis

“…Familial inheritance patterns of NSCP include autosomal dominant inheritance, autosomal recessive inheritance, and X-linked dominant inheritance. Generally, but not in all cases, patients may have strabismus and eyestrain may be secondary to visual occlusion and disruption by the ptotic eyelid [13]. Other ocular symptoms include astigmatism due to eyelid tension and changes in the corneal curvature [14], amblyopia due to astigmatic anisometropia or deprivation [1], and headaches due to forced brow elevation to increase the visual field.…”