Upper eyelid retraction and superior recti stretched scar

Area of Science:

• Ophthalmology
• Strabismus Surgery
• Oculoplastics

Background:

• Stretched scars, characterized by elongated muscle insertions, are a known cause of secondary strabismus.
• While common after medial rectus recessions, stretched scars in superior rectus muscles are less frequently reported.

Purpose of the Study:

• To describe a unique case of upper eyelid retraction.
• To investigate the role of stretched scars in the superior rectus muscles as a cause of this retraction following strabismus surgery.

Main Methods:

• A 26-year-old female patient with persistent upper eyelid retraction and exotropia was evaluated.
• Surgical exploration revealed stretched scars in the superior recti muscles.
• Scarred muscle segments were excised and reattached.

Main Results:

• The patient presented with upper eyelid retraction and exotropia four years post-strabismus surgery.
• Intraoperative findings included stretched scars in both superior recti muscles.
• Postoperative follow-up showed resolution of upper eyelid retraction and orthotropia.

Conclusions:

• Stretched scars in the superior rectus muscles can lead to secondary upper eyelid retraction.
• Surgical management involving excision of stretched scars can effectively treat this complication.