Abstract

14 year old female patient came to opd with mild dropping of the upper eyelid of left eye from birth, which is not associated with pain, bleeding or swelling. There is no history of trauma or surgery previously in that eye. Birth history consists of normal vaginal delivery with immediate crying, no ICU admission and without any significant antenatal history. It is non progressive in nature, without diurnal variation but cosmesis concerning for the patient.
Ophthalmic examination – after doing all the basic examination for ptosis evaluation and strabismus, we found MRD1 =2 mm, MRD2=6 mm with good LPS function=9 mm. Facial symmetry WNL. Head posture WNL & Marcus Gunn jaw winking phenomenon absent. No proptosis of other eye.
Systemic examination – Routine blood examination WNL. MRI brain +orbit= WNL. Ice pack test negative. Anti Myasthenia antibody negative.
Treatment – tarsoconjunctival mullerectomy under GA with 1.5 mm resection of tissue and meticulous suturing of conjunctiva.