title: Comparison between eyelid indices of ptotic eye and normal fellow eye in patients with unilateral congenital ptosis.
abstract: OBJECTIVE
  To evaluate the relationship between levator muscle function (LMF) and other eyelid parameters in the normal and affected eyes of patients with unilateral congenital ptosis.
  
  
  METHODS
  This study includes subjects with unilateral congenital upper lid ptosis who were referred for operation over a 2-year period. Patients with other eyelid abnormalities and previous eyelid surgery were excluded. Eyelid parameters including LMF, lid fissure height (LFH) and margin reflex distance (MRD) were measured in both eyes and analyzed.
  
  
  RESULTS
  A total of 77 patients with mean age of 26.4 ± 16.4 years were enrolled in the study. Mean LMF was 8.3 ± 4.6 mm in the ptotic and 13.1 ± 3.6 mm in the normal fellow eyes. Each millimeter of difference in LMF was associated with 0.30 mm of difference in LFH (95% CI: 0.25-0.35, P < 0.001) and 0.11 mm of difference in MRD of the ptotic eyes (95% CI: 0.08-0.12, P < 0.001) in the same direction. In addition, each millimeter of difference in LMF of ptotic eyes was associated with 0.48 mm of difference (95% CI: 0.33-0.62, P < 0.001) in LMF of non-ptotic eyes in the same direction.
  
  
  CONCLUSIONS
  A direct correlation was observed between LMF, and LFH and MRD in ptotic eyes which confirms the role of levator muscle dysfunction in the development of congenital ptosis and its severity. Furthermore, a direct correlation was also present between LMF of ptotic and non-ptotic eyes suggesting possible bilateral involvement in apparently unilateral congenital ptosis.
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Bagheri
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: mehditavakolimd@yahoo.com.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Tavakoli
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Najmi
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Erfanian Salim
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Shahin
authors.initials: S
authors.lastname: Yazdani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000151:congenital / Q000175:diagnosis* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005143:Eyelids / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
keywords: Levator function; Levator muscle; Lid excursion; Lid fissure height; Ptosis