Ptosis assessment: Current practice across the United Kingdom and future recommendations

Ptosis surgery is one of the most frequently performed oculoplastic operations; however, there is no consensus on standard preoperative assessment at present. The primary aim of this survey was to establish current assessment trends among British Oculoplastic Surgery Society (BOPSS) registered oculoplastic surgeons, identify most frequently used parameters and use these to inform a minimum suggested dataset for recording ptosis assessment.

A web-based questionnaire was created with 24 questions and 5 sub-questions and was reviewed by the BOPSS Executive Committee. It was then sent to 195 BOPSS members and the respondents were invited to complete the survey anonymously over a 2-month period.

There were a total of 88 respondents (45%). Levator function was the most frequently performed measurement, with 99% of the respondents performing this routinely. Other features examined routinely by most respondents included ocular motility (84%), margin reflex distance 1 (83%), pupil responses (75%), skin crease height (73%), dermatochalasis (67%), Bell's phenomenon (66%), contralateral inducible ptosis (65%), brow ptosis (63%) and palpebral aperture (60%).

A proposed ptosis assessment proforma was developed based on the survey findings. This proforma could be used as an aide memoire for junior trainees or allied health professionals in oculoplastic clinics. Furthermore, it could also be used as a minimum dataset for recording ptosis assessment in electronic patient records.