Environmental Factors That Contribute to Upper Eyelid Ptosis: A Study of Identical Twins

Satariano, Nicholas; Brown, Matthew S.; Zwiebel, Samantha; Guyuron, Bahman

doi:10.1093/asj/sju070

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…The U.S. population is aging, 15 and studies have revealed a clear association between increasing age and ptosis incidence. [8][9][10] Contact lens wear, whether rigid or soft lenses, is another common factor that can lead to development of bilateral or unilateral acquired ptosis, [16][17][18][19][20] and patients are now wearing contact lenses for a greater part of their life span because of, for example, availability of multifocal contact lenses for presbyopia. Unilateral or asymmetric acquired ptosis may arise in patients wearing the same or different lenses bilaterally or in patients wearing lenses monocularly.…”

Section: Current State Of Ptosis Diagnosis and Treatmentmentioning

confidence: 99%

Topical Review: An Update of Diagnostic and Management Algorithms for Acquired Blepharoptosis

Nichols¹,

Malloy

Karpecki

et al. 2022

Optom Vis Sci

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SIGNIFICANCE:Acquired ptosis is a condition of the upper eyelid that has negative cosmetic and functional effects but is likely underdiagnosed and undertreated. Given the evolving understanding of the condition and expanding therapeutic options, this review reappraised published evidence and clinical experience regarding diagnosis and treatment of acquired ptosis.The authors met over two structured virtual working sessions to review current evidence and develop timely recommendations for acquired ptosis identification, differential diagnosis, characterization, and treatment selection. Diagnostic algorithms, plus management and referral guidelines, are presented. Eyelid evaluation and, when needed, ptosis diagnostic workup are essential in the comprehensive eye examination. Acquired ptosis can be efficiently identified via patient questionnaire, history, and photograph review combined with assessment of eyelid position and symmetry using established methods. When ptosis is present, it is essential to evaluate onset, symptoms, pupil diameter, and extraocular muscle function to identify or rule out serious underlying conditions. If signs of serious underlying etiology are present, immediate referral/follow-up testing is required. After ruling out serious underlying causes, masquerade conditions, and pseudoptosis, pharmacologic or surgical treatment should be selected based on the clinical evidence. Effectively managing acquired ptosis requires practice-wide commitment to thorough eyelid evaluation, accurate diagnosis, and adoption of new treatment modalities. Aided by evolving pharmacologic therapeutic options, shifting from a "detect and refer" to a "diagnose and manage" approach can support identification and treatment of more patients with acquired ptosis, particularly mild-to-moderate cases.

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Section: Current State Of Ptosis Diagnosis and Treatmentmentioning

confidence: 99%

Topical Review: An Update of Diagnostic and Management Algorithms for Acquired Blepharoptosis

Nichols¹,

Malloy

Karpecki

et al. 2022

Optom Vis Sci

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“…Contact lens wear, which involves repeated manipulation of the eyelid, and therefore the potential risk of microtrauma to the levator aponeurosis, has also been associated with the development of acquired ptosis, with studies linking both hard and soft contact lens wear to increased incidence (Table 2 ) [ 25 – 29 ]. A retrospective analysis of 15 patients with ptosis attributable to contact lens wear revealed that all were hard lens wearers and 13 of 15 had been wearing their lenses for >17 years.…”

Section: Acquired Ptosis Risk Factorsmentioning

confidence: 99%

“…A retrospective analysis of 35 patients aged 18–50 years old presenting with ptosis in a hospital ophthalmology department found that 29 of the 35 patients had a history of either hard or soft contact wear (mean wear time 17.6 and 9 years, respectively) [ 26 ]. A broad analysis of environmental factors contributing to ptosis in 286 sets of adult twins (range: 18–82 years old) found a significant association between both hard and soft contact lens wear and ptosis, but no association with respect to other environmental factors evaluated, including BMI, smoking status, alcohol consumption, hours of sleep per night, or sun exposure [ 29 ]. Consistent with these individual studies, a systematic literature review found significant risk associated with both hard (odds ratio 17.38 (3.71–81.29)) and soft (odds ratio 8.12 (2.68–24.87)) contact lens wear [ 27 ].…”

Section: Acquired Ptosis Risk Factorsmentioning

confidence: 99%

“…A subsequent study of three patients with complex ptosis similarly found objective increases in palpebral aperture and MRD-1, and scleral lens wear was reported by patients to be comfortable [ 63 ]. Still, the overall evidence for scleral lens wear is limited, as are its applications in clinical practice, at least in part because contact lens wear itself can be associated with the development of aponeurotic ptosis [ 25 – 29 ].…”

Section: Acquired Ptosis Treatmentmentioning

confidence: 99%

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A review of acquired blepharoptosis: prevalence, diagnosis, and current treatment options

Bacharach

Lee

Harrison

et al. 2021

Eye

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Blepharoptosis (ptosis) is among the most common disorders of the upper eyelid encountered in both optometric and ophthalmic practice. The unilateral or bilateral drooping of the upper eyelid that characterises ptosis can affect appearance and impair visual function, both of which can negatively impact quality of life. While there are several known forms of congenital ptosis, acquired ptosis (appearing later in life, due to a variety of causes) is the predominant form of the condition. This review summarises the prevalence, causes, identification, differential diagnosis, and treatment of acquired ptosis. Particular attention is paid to the differential diagnosis of acquired ptosis and emerging treatment options, including surgical and pharmacologic approaches.

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“…Several epidemiological studies have suggested a potential association between blepharoptosis and general body condition, especially obesity [10][11][12][13]. These prior studies evaluated obesity using body mass index (BMI), waist circumference (WC), or body fat percentage, and demonstrated that obesity and blepharoptosis are positively associated [10].…”

Section: Introductionmentioning

confidence: 99%

Correlation between body composition and blepharoptosis in adults

Lee

Jeong

2020

Eye

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Background The present study aimed to explore the association between body composition indices, such as fat mass (FM) and lean body mass (LBM), and blepharoptosis. Methods The study evaluated 12,168 Korean adults aged 40 years or older using data from the Korea National Health and Nutrition Examination Survey (2008)(2009)(2010)(2011). FM index (FMI, kg/m 2 ) and LBM index (LBMI, kg/m 2 ) were used to correct for the effects of body size. Multivariable logistic regression analysis was performed to investigate the association between blepharoptosis and body composition indices such as FMI, LBMI, and fat percentage of whole body or head. Stratified analyses were also performed by levator function. Results Higher FMI and head fat percentage were significantly associated with blepharoptosis (adjusted odds ratio [aOR] = 1.35, 95% confidence interval [CI] = 1.10-1.65; and aOR = 1.32, 95% CI = 1.03-1.69 in the highest tertile compared with the lowest, respectively). In the subgroup with good levator function (≥8 mm), higher FMI, head fat percentage, and head lean mass were significantly associated with blepharoptosis (aOR for the right eye [aORr] = 1.42 and aOR for the left eye [aORl] = 1.36; aORr = 1.41 and aORl = 1.37; and aORr = 1.50 and aORl = 1.49 in the highest tertile compared with the lowest, respectively; all p < 0.05). Conclusions Body compositions with high adiposity indices, such as high FMI and head fat percentage, were positively associated with blepharoptosis. Awareness of the potential correlation between obesity-associated fat deposition and blepharoptosis could improve management of the condition and contribute to understanding the pathogenesis of blepharoptosis.

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Environmental Factors That Contribute to Upper Eyelid Ptosis: A Study of Identical Twins

Abstract: 3 Diagnostic.

Cited by 9 publications

References 19 publications

Topical Review: An Update of Diagnostic and Management Algorithms for Acquired Blepharoptosis

Topical Review: An Update of Diagnostic and Management Algorithms for Acquired Blepharoptosis

A review of acquired blepharoptosis: prevalence, diagnosis, and current treatment options

Correlation between body composition and blepharoptosis in adults

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