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M. S. Lee, K. J. Malik, A. R. Harrison; Lash Ptosis in Normal and Ptotic Eyelids. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5481.
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Lash ptosis refers to the downward displacement of the eyelashes in the upper eyelid. The purpose of this study was to determine the prevalence of lash ptosis (LP) in normal eyes and those with congenital or acquired ptosis.
A database search for patients with congenital and acquired ptosis seen by a single oculoplastics provider at the University of Minnesota was performed. Only patients with external photography were included. Three masked evaluators graded photographs for the degree of LP in normal eyes and those with congenital or acquired ptosis. Each patient was assessed using a semi-quantitative 4 point rating scale for LP [0 = none, 1 = minimal, 2 = moderate, 3 = significant]. Any discrepancy greater than 1 rating was adjudicated in an unmasked fashion.
A total of 107 eyes of 87 patients demonstrated ptosis in the congenital group and 121 eyes of 87 patients in the acquired group. Some degree of lash ptosis (rating ≥ 1) was present in 91.6% of congenital ptosis eyes, 83.5% of acquired ptosis eyes, and 27.5% of normal eyes. A moderate to significant rating of LP (rating ≥ 2) occurred in 60.7% of congenital ptosis eyes, 28.9% of acquired ptosis eyes, and 9.2% of normal eyes. The average LP rating was 2.08 for congenital ptosis (95% confidence interval (CI): 1.93-2.23), 1.30 (95% CI: 1.03-1.57) for acquired ptosis, and 0.58 (95% CI: 0.45 - 0.72) for normal eyes.
Compared to normal eyes, lash ptosis is common among eyes with ptosis especially the congenital form. Clinicians should note the degree of LP in the preoperative evaluation and consider addressing it in their surgical approach.
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