Patient: My daughter was born with a delayed opening of her left eye, and later found that her left eye was about 1/2 smaller than her right eye. At four months, she was seen at the City Children’s Hospital, where she was told that her left eye had congenital ptosis. If early surgery is needed, which is less damaging to the baby in the long run, frontalis suspension or frontalis flap suspension? This is because the eyelid muscles are not yet well developed. Guangzhou Children’s Hospital Ophthalmology Department: The choice of surgery is made by the doctor based on a comprehensive consideration of the condition. Either surgery is to help open your child’s eyes, so it is not a damage to your baby. As far as I can see, the condition of your child’s eyes is not particularly serious and if the pupil is not obscured, there is no need to operate too early. If you operate too early, it will be relatively difficult to shape the eyelids during surgery because they are not fully developed; on the other hand, even if the surgery is successful too early, there is a greater likelihood that the shape of the eyelids will change during development. Regardless of what other doctors recommend, I would suggest that if there is no risk of deprivation amblyopia due to masking in the ptosis eye, surgery after the age of 3 is more appropriate. Patient: Thank you Dr. Xiang, my daughter’s left eye has a partially occluded pupil, she looks at things with raised eyebrows and a bit of a raised head, how much occlusion do you think is necessary for early surgery to prevent amblyopia? Dao Man Xiang, Ophthalmology Department, Guangzhou Children’s Hospital: In most cases, even if the pupil of the ptosis eye is partially covered, the child will be able to use the diseased eye by looking at things with a raised eyebrow and a little bit of head lift. Therefore, when a child has a raised eyebrow, tilted head, etc., it is an indication that the eye with ptosis is being used frequently and there is no possibility of deprivation amblyopia due to masking, so surgery at too early an age is not necessary.