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Unilateral ptosis and eye dominance
D B Lyon1, R S Gonnering, R K Dortzbach
1Department of Ophthalmology, University of Wisconsin, Madison.
Ophthalmic Plastic and Reconstructive Surgery
|December 1, 1993
Summary
Eye dominance influences levator muscle tone in ptosis patients. Preoperative tests like Scobee and phenylephrine can reveal contralateral upper lid pseudoretraction, aiding diagnosis.
Area of Science:
- Ophthalmology
- Neuroscience
Background:
- Unilateral or asymmetric bilateral ptosis presents diagnostic challenges.
- Understanding factors influencing upper eyelid position is crucial for effective ptosis management.
Purpose of the Study:
- To investigate the relationship between eye dominance and upper eyelid level in patients with ptosis.
- To determine if eye dominance affects contralateral upper lid pseudoretraction following phenylephrine instillation.
Main Methods:
- Evaluated 54 patients with unilateral or asymmetric bilateral ptosis.
- Utilized the Scobee test for eye dominance and the phenylephrine test for upper lid response.
- Measured margin-to-reflex distance (MRD) and contralateral lid drop.
Main Results:
- Contralateral lid drop occurred in 12/54 patients after phenylephrine instillation.
- A significant association was found between greater ptosis in the dominant eye and contralateral lid drop (p = .01).
- Contralateral lid drops ≥1 mm were significantly more common in patients with greater ptosis on the dominant side (p = .001).
Conclusions:
- Levator muscle tone appears to be influenced by eye dominance in the presence of ptosis.
- Preoperative assessment should include the Scobee and phenylephrine tests to identify contralateral upper lid pseudoretraction.
- These tests aid in the comprehensive evaluation of ptosis and potential surgical planning.