Correlation of the vision-related functional impairment associated with blepharoptosis and the impact of blepharoptosis surgery

Objective: To assess the effect of blepharoptosis on patients' visual funct ion and health related quality of life and to determine what measures are a ssociated with postsurgical change in functional status. Design: Prospective, observational case series. Participants: One hundred patients with unilateral or bilateral blepharopto sis. Intervention/Main Outcome Measures: Preoperative and postoperative upper ey elid position (i.e., margin reflex distance [MRD]) and superior visual fiel d (SVF) height, as well as subjective visual function and health-related qu ality-of-life functional status before and after ptosis surgery. Results: There was a mean 30-point increase in functional index score after ptosis repair (P < 0.001). Lower (more ptotic) preoperative upper eyelid p osition and SVF (combined eye) were associated with greater change in funct ional index after surgery (r = -0.290, P = 0.007 and r = -0.39, P = 0.003, respectively). Preoperative visual field testing with manual lid elevation was not significantly correlated to the postoperative change in functional index (P > 0.100), The strongest correlation of postoperative functional in dex change was with the preoperative functional status (r = -0.79, P < 0.00 1). Conclusions: Patients' functional status is reduced by blepharoptosis, and surgical repair results in measurable increase in health-related quality of life. Patients' self-reported preoperative functional impairment is most s trongly associated with the degree of postsurgical functional improvement.