A brief description of the treatment of congenital ptosis

  It is mainly due to hypoplasia of the levator muscle or abnormal development of the nerve that innervates it, with a prevalence of about 1.2 per 1,000 people. The clinical manifestation is that the upper lid cannot be lifted sufficiently when the patient looks straight ahead, and the upper lid margin covers part or all of the pupil, making it difficult for the patient to see, requiring the patient to raise the forehead or head to raise the upper lid to see, which, in children, affects psychological development because of poor appearance and, in the long term, can lead to amblyopia or cervical spine deformity.  Therefore, it is believed that this disease should be treated as early as possible and that surgery is the only effective method of treatment. In the early years, surgery was recommended at the age of 5 to 6 years before school, but in recent years, due to the increased understanding of psychological medicine and the increased surgical refinement of surgeons, surgery can be considered for children 2 to 3 years old in hospitals with strong technical skills.  Clinically, ptosis is classified as mild, moderate or severe depending on the degree of ptosis. The two main surgical methods that are more effective today are levator shortening and frontalis flap suspension. In children with mild ptosis, the upper eyelid lift can be shortened to achieve a satisfactory correction, while in patients with moderate to severe ptosis, a frontalis flap suspension is usually required to achieve the desired correction. In addition, due to the poor development of the ocular muscles before the age of 3 years, the levator aponeurosis is generally not performed and only the frontalis flap suspension is performed.  Because the correction of congenital ptosis is not a simple procedure, but rather a risky and complex one, the surgeon must have a solid knowledge of local anatomy and excellent surgical skills, which can only be trained by plastic surgery or ophthalmology at a major hospital. The patient should go to the plastic surgery or ophthalmology department of a large hospital with strong technical capabilities to ensure a satisfactory treatment effect.