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Review
. 2018 Sep;97(36):e12124.
doi: 10.1097/MD.0000000000012124.

Ptosis in childhood: A clinical sign of several disorders: Case series reports and literature review

P Pavone  1 , Sung Yoon Cho, A D Praticò, R Falsaperla, M Ruggieri, Dong-Kyu Jin
Affiliations
Review

Ptosis in childhood: A clinical sign of several disorders: Case series reports and literature review

P Pavone et al. Medicine (Baltimore). 2018 Sep.

Abstract

Blepharoptosis (ptosis) is a common but often overlooked sign that may serve as a sign/manifestation of other conditions, ranging from a mild and purely cosmetic presentation to a severe and occasionally progressive disorder. Ptosis may show an acute onset or may manifest as a chronic disorder. Its presentation may vary: unilateral versus bilateral, progressive versus non-progressive, isolated versus complex which occurs in association with other symptoms, and congenital versus acquired (often concomitant with neuromuscular disorders).Congenital ptosis includes the isolated type-the congenital cranial dysinnervation disorders, which are further, distinguished into different subtypes such as Horner syndrome (HS), and ptosis as a sign/manifestation of various congenital malformation syndromes.In this article, we review the primary causes of ptosis occurring in childhood, and its various clinical presentations, including a short report on selected cases observed in our institution: a classical isolated familial ptosis comprising 14 members over 5 generations, 3 sibling with isolated congenital ptosis who in addition suffered by episodes of febrile seizures, a patient with Duane retraction syndrome who presented congenital skin and hair anomalies, and a girl with HS who showed a history of congenital imperforate hymen. A flowchart outlining the congenital and acquired type of ptosis and the clinical approach to the management and treatment of children with this anomaly is reported.

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Conflict of interest statement

The authors declare that they have no competing interests.

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Representation of eyelid muscles and their innervation.
Figure 2
Figure 2
Measurement of the palpebral fissure height with a ruler.
Figure 3
Figure 3
A&B. Eyelid measurement with a ruler using a pointing with a finger.
Figure 4
Figure 4
Image showing isolated congenital ptosis in a 2-year-old boy.
Figure 5
Figure 5
Image showing isolated congenital ptosis in a 12-year-old girl.
Figure 6
Figure 6
Image showing a 4-year-old boy with ptosis. Isolated congenital ptosis was also observed in his sister and brother. All 3 children presented with ptosis and episodes of febrile seizures.
Figure 7
Figure 7
Image showing a 10-year-old boy with Duane retraction syndrome. Ptosis (A) is observed to be associated with café-au-lait spots in the trunk (B), and piebaldism (C).
Figure 8
Figure 8
Flow chart outlining ptosis: congenital (A) and acquired (B) types.
See this image and copyright information in PMC

References

    1. Yadegari S. Approach to a patient with blepharoptosis. Neurol Sci 2016;37:1589–96. - PubMed
    1. Elsevier, Swaiman KF, Ashwal S, Ferriero DM, Schor NF. Swaiman's pediatric Neurology. Principles and Practice. 5th ed. 2017;62–65.
    1. Baroody M, Holds JB, Vick VL. Advances in the diagnosis and treatment of ptosis. Curr Opin Ophthalmol 2005;16:351–5. - PubMed
    1. Gomez J, Laquis SJ. Blepharoptosis: clinical presentation, diagnosis, and treatment. Insight 2015;40:5–9. - PubMed
    1. Wilson II FM, Blomquist P. External examination. In: American Academy of Ophthalmology. Practical Ophthalmology. San Francisco; 2009:132–4.