The management of the ptosis patient: Part I

The various types of congenital and acquired ptosis are discussed as well as the findings on history and examination. From this information the appropriate operation can be chosen. Emphasis is placed on obtaining accurate and reproducible measurements in addition to assessing visual acuity, extraocular muscle movement, Bell's phenomenon, and tear secretion, especially in older patients. The operations described are the tarsal-Muller's muscle resection, levator aponeurosis advancement, levator resection, and frontalis suspension. Since the aim in ptosis surgery is symmetry in the primary position, overcorrections and undercorrections must occasionally be dealt with to achieve a satisfactory result.