Evaluation and management of unilateral ptosis and avoiding contralateral ptosis

Treating unilateral ptosis can be challenging and a proper preoperative evaluation may help prevent unexpected outcomes on the contralateral lid. Preoperative evaluation should include testing for Hering's law, which remains useful in understanding the phenomenon of induced contralateral eyelid...

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Bibliographic Details
Published in:Aesthetic surgery journal 2010-05, Vol.30 (3), p.320-328
Main Authors: Zoumalan, Christopher I, Lisman, Richard D
Format: Article
Language:English
Subjects:
Adolescent
Aged
Blepharoptosis - etiology
Blepharoptosis - physiopathology
Blepharoptosis - surgery
Eyelids - physiopathology
Female
Humans
Male
Middle Aged
Postoperative Complications - etiology
Postoperative Complications - prevention & control
Preoperative Care - methods
Severity of Illness Index
Young Adult
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Summary:Treating unilateral ptosis can be challenging and a proper preoperative evaluation may help prevent unexpected outcomes on the contralateral lid. Preoperative evaluation should include testing for Hering's law, which remains useful in understanding the phenomenon of induced contralateral eyelid retraction in the context of ptosis. Approximately 10% to 20% of patients with unilateral ptosis have some degree of induced retraction on clinical evaluation in the contralateral lid. When there is a positive Hering's test on preoperative examination, the surgeon should consider a bilateral ptosis procedure. The surgical approach to unilateral ptosis depends on the severity of the ptosis and its etiology, and the surgeon should be aware of which procedure is most likely to provide the best outcome in selected instances.
ISSN:1090-820X
1527-330X
DOI:10.1177/1090820X10374108