Purpose: The aim of this study was to evaluate the changes in corneal topography, cycloplegic refraction, and best-corrected visual acuity (BCVA) after ptosis correction surgery in patients with congenital ptosis. Methods: Our study represents a prospective observational study conducted on 27 eyes of 21 patients with congenital ptosis. All patients underwent complete ophthalmological evaluation, cycloplegic refraction, and baseline Orbscan prior to ptosis surgery. At 6 months postoperative review, the cycloplegic refraction and Orbscan were repeated to evaluate the changes in these parameters. The main outcome measures in our study were Steepest K, Inferior-Superior Asymmetry (I-S Asymmetry), cycloplegic refraction and BCVA. Results: A significant decrease in Steepest K postoperatively ( P < 0.001) was noted. Superior K and Inferior K also decreased, but the decrease in Inferior K was statistically significant ( P = 0.044). However, change in I-S Asymmetry was not significant. Variation in BCVA, and cycloplegic sphere and cylinder was minimal. Sim K astigmatism, Surface Regularity Index, I-S Asymmetry and Central Corneal Thickness did not show significant variation. Conclusion: Ptotic eyelid constantly presses on the cornea causing significant changes in corneal contour and surface remodeling. This pressure when relieved, results in significant flattening and regression of anterior corneal surface to its near normal anatomy. This further resulted in improvement of corneal surface irregularity and symmetry.

Ophthalmia nodosa is an inflammatory reaction of ocular tissues in response to caterpillar setae. Setae are fibers produced by a number of insects and plants, and there are extensive reports of cases caused by caterpillars and spiders. These hairs are covered by microscopic barbs that facilitate their entry and migration into the ocular tissues resulting in severe inflammation. They are predominantly found buried in the conjunctiva and cornea. Rarely, they may penetrate through the cornea to enter the anterior chamber, lens, and posterior segment. Caterpillar hair in the meibomian gland orifice is a rare presentation and has not been reported previously.