Actinic nerve palsy must, first and foremost, be ruled out as a life-threatening cause. Pupillary abnormalities usually suggest the presence of compression factors, but the sign is not specific, and pupillary abnormalities are due to microangiopathy in approximately 20% of patients. Overall, complete ptosis should be considered for surgical treatment; most patients can be treated conservatively with masking or trismus. Surgical treatment of actinic nerve palsy must be weighed against the pros and cons, and usually has limited efficacy and potential surgical complications. Fan Chunlei, Ophthalmology Department, Beijing Aiyoungzhi Eye Hospital, Beijing, China I. The purpose of surgery and the timing of surgery should be considered after the eye position has been stable for more than 6 months. In patients with complete ophthalmic nerve palsy, surgery can be considered to adjust the eye position and improve the appearance after the ptosis has recovered on its own (or after surgery). The sole purpose of surgery for complete oculomotor nerve palsy is to improve aesthetics. It is difficult to improve oculomotor function with surgery, and it is impossible to restore monocular function in both eyes. The purpose of surgery for incomplete articular nerve palsy is different. After surgery, the original in-position can be maintained in an orthotropic position and the range of binocular monocular vision can be expanded. II. Preoperative evaluation of eye position: check the degree of external and inferior strabismus in the original incumbent position; oculomotor function: check the residual function of the extraocular muscles and determine the degree of motoneural nerve palsy. Determine whether the function of the external rectus and superior oblique muscles is normal; passive retraction test and active retraction test; Hess screen periodic examination reflecting the stability of the actinic nerve palsy; record any abnormal nerve regeneration; preoperative communication of the fundamental purpose of surgery in patients with complete actinic nerve palsy is to improve the appearance; postoperatively, the diplopia caused by the similar two object images being closer together is difficult to overcome, and masked contact lenses can be tried; external recurrence of strabismus; rotational diplopia occurring after superior oblique muscle key-breaking or transposition.