Subject Area


Article Type

Original Study



To compare the different methods of clinical evaluation of upper eyelid congenital blepharoptosis and discuss the utility of margin-reflex distance (MRD1) over levator muscle function (LF) in choosing the appropriate surgical procedure for congenital blepharoptosis correction.


The amount of the cornea covered by the eyelid varies, resulting in visual disturbances and cosmetic problems. Surgical correction is the mainstay treatment of congenital blepharoptosis; therefore, our study uses MRD as a determinant for choosing the appropriate surgical intervention for ptosis correction.

Patients and methods

This was a prospective study conducted on 20 patients with upper eyelid ptosis based on clinical data on patients with upper eyelid ptosis. All cases were examined clinically and followed 3 months after surgery. In all cases, levator resection was performed when LF was more than 4 mm.


MRD1, palpebral fissure height, and levator function degree were significantly increased postoperatively than preoperatively (P


The MRD at a cutoff point of 0.5 mm may be used as an alternative to LF to determine the type of surgical intervention in patients with congenital blepharoptosis whose LF cannot be reliably obtained in clinical evaluations.