Contributor: Jesse Vislisel, MD
Congenital blepharoptosis or ptosis is usually non-hereditary, but can be associated with blepharophimosis syndrome, an autosomal dominant condition. Most commonly, it is due to dysgenesis of the levator muscle and the presence of fibroadipose tissue in the muscle belly. These patients present with poor levator function, an absent upper lid crease, eyelid lag, and occasionally lagophthalmos. Less common causes are aponeurotic, sometimes caused by birth trauma, or neurogenic. This patient had bilateral myogenic congenital ptosis affecting the left eye more severely than the right. Note the absent upper lid crease and the peaked eyebrows secondary to frontalis overactivation.
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