title: Congenital ptosis and amblyopia.
abstract: OBJECTIVE
  To investigate the incidence and causes of amblyopia in congenital ptosis.
  
  
  METHODS
  The frequency and causes of amblyopia were evaluated in 83 eyes of 72 patients with congenital ptosis. Patient ages ranged between 10 months and 70 years. Amblyopia was defined as best-corrected visual acuity of 0.7 or less. After a complete ophthalmologic examination, the amount of ptosis and levator function was determined and the following amblyogenic factors were identified: ametropia, anisometropia, and strabismus. In cases with no other reason for amblyopia, stimulus deprivation amblyopia due to ptosis was assumed.
  
  
  RESULTS
  The amount of ptosis was mild in 5 (6%), moderate in 26 (31%), and severe in 52 (63%) of 83 eyes with congenital ptosis. Strabismus was present in 17 (20%) eyes. Visual acuity could not be determined in 10 of 83 eyes with ptosis in children younger than 4 years. The overall incidence of amblyopia in the remaining 73 eyes was 48%. Of those patients with amblyopia, 54% had refractive errors such as anisometropia or ametropia, 20% had strabismus with or without refractive errors, and 26% had amblyopia solely attributed to ptosis. When all eyes with ptosis were included, the rate of stimulus deprivation amblyopia was 12% and all of these eyes had severe ptosis.
  
  
  CONCLUSIONS
  Early detection and treatment of amblyogenic factors such as refractive errors and strabismus is recommended and, when the pupillary axis is occluded with severe ptotic eyelids, surgery should be performed as soon as possible to prevent stimulus deprivation amblyopia.
authors.affiliation: Dr. Lutfi Kirdar Training and Research Hospital, 1st Eye Clinic, Istanbul, Turkey.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Oral
authors.forename: Ozlen Rodop
authors.initials: OR
authors.lastname: Ozgur
authors.forename: Levent
authors.initials: L
authors.lastname: Akcay
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozbas
authors.forename: Omer Kamil
authors.initials: OK
authors.lastname: Dogan
mesh_terms: D000015:Abnormalities, Multiple; D000293:Adolescent; D000328:Adult; D000368:Aged; D000550:Amblyopia / Q000151:congenital* / Q000453:epidemiology / Q000503:physiopathology; D019882:Blepharoplasty; D001763:Blepharoptosis / Q000151:congenital* / Q000453:epidemiology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D015994:Incidence; D007223:Infant; D008875:Middle Aged; D012029:Refraction, Ocular; D014421:Turkey / Q000453:epidemiology; D014792:Visual Acuity; D055815:Young Adult