Refractive error, strabismus and amblyopia in congenital ptosis.

INTRODUCTION

Congenital ptosis is often associated with visual impairment. The aim of the study is to find out the pattern of refractive error, strabismus and amblyopia in patients with congenital ptosis in a hospital setting.

METHODS

This is a hospital based prospective and descriptive study conducted at Tribhuvan University, B P Koirala Lion's Centre for Ophthalmic studies in Nepal from February 2003 to July 2004. All the consecutive cases with congenital ptosis were included and cases with pseudoptosis were excluded from the study.

RESULTS

Among the 78 cases (95 eyes) of congenital ptosis, refractive error was present in 13 cases (16.7%) with astigmatism as the commonest refractive error (8.9%). Strabismus was found in 23 cases (26.9%) of congenital ptosis. Among the strabismus, combined exotropia with hypotropia was found in the majority of cases (16.7%). Visual impairment due to amblyopia was found in 15 cases (19.2%) of congenital ptosis with mixed strabismic and refractive etiology as the commonest one (46.7%) followed by pure strabismic (26.7%), pure refractive (20%) and stimulus deprivation amblyopia (6.7%).

CONCLUSIONS

Patients with congenital ptosis have higher rate of amblyopia due to greater prevalence of strabismus and refractive errors although stimulus deprivation amblyopia is less common. Early ophthalmic evaluation and timely treatment of these conditions may help prevent the irreversible visual impairment in case of congenital ptosis.