In a patient with chronic progressive external ophthalmoplegia and bilateral ptosis obscuring the visual axis. Would you perform levator resection or brow suspension and why? Answer In chronic progressive external ophthalmoplegia, the patient has poor Bell's phenomenon. In addition, most of this patients eventually develop orbicularis oculi weakness. If levator resection was performed, there may be corneal expsoure when orbicularis oculi weakness develops due to unopposed levator function. Brow suspension is preferable. Even then it is important to be conservative due to the risk of corneal exposure. What are the complications of ptosis surgery? Answer Complications of any operations can be classified into those that occur in all operations and those that are specific to a particular operation. Haemorrhage and infections are the non-specific complilcations of all operations. Complications specific to ptosis surgery are: Over or under-correction and eyelid contour abnormalities. Corneal expsoure causing expsoure keratopathy Conjunctival prolapse Contralateral ptosis Orbital haemorrhage Following a sucessful ptosis surgery. A patient complains of blurred vision but examination shows no evidence of corneal abnormalites. What may be responsible for this? Answer Refractive error due to changes in the corneal topography following ptosis operation. Studies have shown changes in the corneal contour following ptosis operation and this is thought to be caused by changes in the pressure effect of the eyelid on the corneal surface.
What are the complications of ptosis surgery?
Following a sucessful ptosis surgery. A patient complains of blurred vision but examination shows no evidence of corneal abnormalites. What may be responsible for this?