Congenital ptosis is a common pediatric eye condition. It is a condition in which the upper eyelids of one or both eyes cannot be opened or do not open much, commonly known as “long eyelids” or “squinting eyes”. In order to see clearly what is in front of him, the child often lifts his chin and raises his eyebrows at the same time, forming the typical posture of raising his head and eyebrows. After a long time, the horizontal wrinkles on the child’s forehead will become more and more obvious, which is often referred to as head-lift lines, making the child look like a “little old man”. So, how does this “eyelid growth” occur? Does it have any effect on eye development? How is it treated? First, let’s understand the causes of ptosis. The majority of congenital ptosis is due to hypoplasia of the levator muscle, or a disorder of the central and peripheral nerves that govern it, and is inherited in an autosomal dominant fashion, which means it is more likely to be inherited. In addition, acquired conditions include actinic nerve palsy, sympathetic nerve disease, myasthenia gravis, and mechanical lid opening dyskinesia. Congenital ptosis can have a significant impact on eye development, especially in severe ptosis, which obscures the pupil, limits the visual perception of the eye to external objects, disrupts visual development, and can easily cause amblyopia. Treatment for ptosis can be tailored to different causes. Congenital ptosis should be corrected with early surgery. Currently, we believe that the best age for surgery for congenital ptosis is between the ages of 3 and 5 years old, or earlier, around 2 years old, for patients with particularly severe cases. Surgical options for ptosis include: strengthening the levator muscle, such as shortening or migrating the anterior muscles; and opening the lid fissure with the help of the traction force of the frontalis muscle. Different surgical options can be chosen depending on the condition and the strength of each muscle. After measuring the strength of the levator muscle before surgery, the surgeon will design a surgical plan based on the specific situation so that the eyes are symmetrical and aesthetically pleasing after surgery. In our clinical practice, we have found that many people, including our colleagues, believe that the child should be older before surgery, which is actually inappropriate. Parents often think that surgery for young children requires general anesthesia, which is risky and also afraid of any adverse consequences for the child, and that local anesthesia can be taken when the child grows up, so they want to let the child grow up a bit before surgery, in fact, general anesthesia will not affect the growth and development of the child. If the surgery is too late, amblyopia will be formed, but it will have a negative impact on the child’s physical and mental development. Therefore, it is important to try to treat your child at the best time for surgery.