Purpose:

To evaluate refractive error and amblyopia in cases of congenital ptosis with and without covered center of the pupil.

Material and Method:

Medical records of 37 patients with congenital ptosis were retrospectively evaluated from the perspectives of refractive error, ocular motility, strabismus, and amblyopia. The patients were divided in two groups: with and without covered center of the pupil.

Result:

Of the 37 patients, 14 were female and 23 were male with a mean age of 6.49 (1-13) years. 30 cases had unilateral ptosis and 7 had bilateral ptosis. In 25 eyes, the pupil was obscured by the ptotic eyelid (group 1) and in 19 eyes-was not covered (Group 2). In the cases of unilateral ptosis, anisometropia was detected in 4 patients with and in 2 patients without covered center of the pupil. Astigmatism was determined in 13 eyes, 7 of which were unilateral ptotic and 6 were bilateral ptotic eyes. Incidence of astigmatism was found nearly four times more in cases of bilateral ptosis than in cases of unilateral ptosis covering the pupil. In 6 eyes with unilateral ptosis and in 2 eyes with bilateral ptosis, strabismus and ocular motility disorders were observed. Amblyopia was detected in 15 eyes. In one patient with covered center of the pupil and no refractive errors, the ambylopia was directly attributed to the stimulus deprivation caused by ptosis.

Discussion:

Strabismus, astigmatism, anisometropia and amblyopia are frequently encountered in patients with congenital ptosis. Contrary to expectations, in patients with congenital ptosis, amblyopia resulting from occlusion of pupil is rare. Ptosis is not the only factor responsible for the development of amblyopia. Refractive examinations of such patients should be done carefully and comprehensively.

Keywords: Congenital ptosis, amblyopia, strabismus, astigmatism, anisometropia