Oxymetazoline and Blepharoptosis: A Case Series and Proposed Treatment Algorithm

Area of Science:

• Ophthalmology
• Pharmacology

Background:

• Blepharoptosis, or drooping upper eyelids, impacts vision and quality of life.
• Traditional treatments include observation, medications with side effects, and surgery.
• Oxymetazoline ophthalmic solution (FDA-approved 2020) presents a novel, low-adverse-effect option.

Observation:

• This study evaluated oxymetazoline's use in five blepharoptosis patients.
• A clinical assessment determined patient response to oxymetazoline.
• A treatment algorithm was developed based on the oxymetazoline test response.

Findings:

• Oxymetazoline demonstrated efficacy in improving eyelid elevation and visual field.
• Favorable responses guided decisions towards internal ptosis repair.
• Suboptimal responses suggested external ptosis repair, with options for blepharoplasty.
• The test also served as an interdependence test for asymmetric/unilateral ptosis.

Implications:

• Oxymetazoline serves as a diagnostic tool and pre-surgical therapy for blepharoptosis.
• Its efficacy and safety profile make it a valuable clinical option.
• The proposed algorithm streamlines clinical decision-making and enhances patient outcomes.