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Updated: Jun 28, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Paediatric blepharoptosis: a 10-year review
1Eye Department Birmingham Children's Hospital, Birmingham, UK. aberrybrincat@hotmail.com
Insights
Surgical outcomes for pediatric blepharoptosis (droopy eyelid) show a 71% success rate with one operation. Children with ptosis require ongoing monitoring for amblyopia, strabismus, and refractive errors.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Blepharoptosis, or droopy eyelid, is a common condition in children.
- Surgical intervention is often necessary to correct ptosis and improve vision.
Purpose of the Study:
- To evaluate the characteristics of pediatric blepharoptosis.
- To assess the success rates of surgical interventions for blepharoptosis in children.
Main Methods:
- Retrospective review of 155 children (186 eyes) undergoing blepharoptosis surgery over ten years.
- Analysis of aetiology, severity, surgical techniques, outcomes, complications, and reoperation rates.
Main Results:
- Levator resection was the most common procedure (71%).
- Successful correction was achieved in 70.97% of cases with a single surgery.
- Reoperation was needed in 19.89% of cases.
- Amblyopia (26.45%), strabismus (14.19%), and refractive errors (18.70%) were common comorbidities.
Conclusions:
- Early ophthalmological referral is crucial for pediatric blepharoptosis.
- Children with congenital ptosis require lifelong monitoring for amblyopia, strabismus, and refractive errors, as these can develop post-operatively.
Purpose:
To examine the characteristics of blepharoptosis and the success of surgical intervention in a large group of children presenting to a specialist at paediatric ophthalmology center.
Methods:
Ten-year retrospective case notes review of patients presenting to the Birmingham Children's Hospital for blepharoptosis surgery. Resultant database was interrogated for aetiology of ptosis; severity; surgical correction; outcome; complications and need for reoperation.
Results:
One hundred and fifty five children (186 eyes) underwent blepharoptosis surgery. Hundred and ten patients (71%) were treated with a levator resection procedure, 28 (18%) underwent a brow suspension using Mersilene mesh, 15 (10%) with Fasanella Servat procedure and 2 (1%) with La Mange procedure. The mean post-operative follow-up was 30.82 months with 84 children completing a minimum of 12 months follow-up. Overall, 70.97% lids were successfully corrected with a single operation. In 9.14% lids, the results were fair but no further surgery was carried out. Reoperation was required in 19.89% of lids with the mean time to second surgery being 32.69 months. Amblyopia was found in 26.45% (41 children); in 3 patients, their amblyopia became manifest after the ptosis surgery. A concomitant squint was present in 14.19%, and 18.70% had a significant refractive error requiring spectacles prescription, with anisometropia present in more than 72% of these patients.
Conclusions:
Early referral to an ophthalmologist is necessary even though surgical correction may be delayed. Children with congenital ptosis need to be monitored for amblyopia both pre- and post-operatively, as the incidence of strabismus and refractive errors is much higher than the general population and these may develop even after ptosis surgery.
