Acquired blepharoptosis secondary to contact-lens wear

Five patients (eight eyelids) had acquired blepharoptosis after using contact lenses. The ages (26 to 55 years) of these patients was not consistent with idiopathic senile blepharoptosis, and we excluded all other possible causes. All patients had disinsertion and recession of the aponeurosis of the levator palpebrae superioris muscle, and the blepharoptosis improved in each case after reattachment of the aponeurosis to the superior tarsal border. We believe there is a cause-and-effect relationship between the use of contact lenses and the acquisition of secondary blepharoptosis. The most likely explanation of this type of blepharoptosis is difficulty in inserting and removing the lenses. Thus, excessive eyelid manipulation may disinsert the aponeurosis of the levator palpebrae superioris muscle from the tarsus.