Prevalence of refractive errors and corneal topographic changes in unilateral congenital ptosis vs the fellow eye: a clinical study

Nitin V. Vichare


Background: This study was undertaken to assess the effect of upper eyelid pressure on refractive errors and corneal topography in eyes with ptosis and compare it with fellow normal eyes.

Methods: This cross-sectional observational study involved 83 patients with unilateral congenital ptosis. Evaluation of ptosis done to classify it into mild, moderate and severe. Manual refraction and corneal topography done to obtain refractive errors, astigmatism, keratometric data and topographic patterns. These values in eyes with ptosis were compared with that in fellow nonptotic eyes.

Results: Around 21.69% participants had mild ptosis, 36.14 % had moderate and 42.17% had severe ptosis. 19.28 % eyes with ptosis were myopic as compared to 12.05 % eyes without ptosis. 16.86 % eyes with ptosis had hyperopia as compared to 2.41 % normal eyes. 45.78% eyes with ptosis had significant refractive astigmatism compared to 6.02% fellow eyes. 57.83 % of eyes with ptosis had significant Sim K astigmatism as compared to 28.92 % normal eyes. The prevalence of refractive errors increased with the severity of ptosis. Majority of eyes with ptosis (53.01 %) had symmetrical bow tie pattern compared to round pattern seen in most of the normal eyes (39.76%).

Conclusions: Upper eyelid pressure in ptosis causes significant refractive and corneal topographic changes. The greater prevalence of Sim K astigmatism (57.83%) than refractive astigmatism (45.78%) underlines the need of corneal topography in all cases to ensure timely detection of astigmatism and institution of proper corrective measures to prevent development of amblyopia.


Astigmatism, Corneal topography, Congenital ptosis, Refractive error

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