Quantification of palpebral fissure shape in severe congenital blepharoptosis

Purpose: To measure palpebral fissure morphology in patients with severe co ngenital blepharoptosis. Methods: The palpebral fissure shape of 20 patients (30 eyes) with severe c ongenital blepharoptosis (levator excursion less than or equal to 4 mm) was quantified with digital image processing in a cross-sectional design. Seve ral variables related to the morphology of the palpebral fissure were measu red: (a) upper and lower eyelid curvature, (b) palpebral fissure angle, and (c) position of the upper maximum and lower minimum eyelid contour. Results: Patients with severe congenital blepharoptosis often show a modera te degree of antimongoloid palpebral fissure orientation and eyelid droopin g that is greater temporally than nasally. Conclusions: Contour adjustment in severe congenital blepharoptosis surgery is better when it is not centered on the midline, but rather has a slight lateral displacement.