Oculoplastic Surgery Atlas by Geoffrey J. Gladstone Frank A. Nesi & Evan H. Black

Author:Geoffrey J. Gladstone, Frank A. Nesi & Evan H. Black
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Surgical Decision-Making

The most important factors in differentiating aponeurotic from muscular ptosis are history, Burke levator function, eyelid crease position, and fissure width in downgaze (Table 5.1). In aponeurotic ptosis the patient will typically have good levator function (between 12 and 18 mm). The history is that of gradual onset beginning in middle-to-later life. The eyelid crease is characteristically elevated. Since the levator muscle is stretched or detached, it does not perform the function of a check ligament in downgaze, and the fissure width in downgaze is narrowed and sometimes actually closed (Table 5.1).Table 5.1.Factors distinguishing aponeurotic from muscular ptosis

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