Blepharoptosis. Etiology and epidemiology.

The etiologies and epidemiological characteristics of the 130 cases of blep haroptosis seen at the Reims Teaching Hospital between 1992 and 1997 are re viewed. Congenital ptosis was the leading cause, followed by ocular nerve p alsy, then in order of decreasing frequency ptosis of unknown cause in adul ts, fascial avulsion, Horner's syndrome, isolated myasthenia, trauma, and m yopathy. There was a male predominance (59%). The ptosis was unilateral in 96 cases (74%). The eyelid droop was 2 to 4 mm in 58% of cases and more tha n 4 mm in 26%. The upper third of the pupil was covered in 28% of cases, th e upper half in 37% of cases, and the entire pupil in 4%. Function of the l evator palpebrae superioris was normal in 49% of cases and fair in 32%. Pos ition of the palpebral sulcus was normal in 73% of cases but was displaced upward in patients with fascial avulsion. Resection of the levator palpebra e superioris was done in 53% of cases, resection of the conjunctiva and Mul ler's muscle in 20%, reimplantation of the fascia in 23%, and suspension to the forehead in 4%. Overall, results were good in 86% of cases, fair in 12 %, and poor in 2%.