Characteristics of Ptosis presentation at Dhulikhel Hospital: A cross-sectional study

Abstract

Ptosis is a common oculoplastic disorder that ranges from a cosmetic concern to a cause of visual impairment. This study aimed to describe the demographic profile, clinical features, etiological patterns, and visual impact of ptosis at a tertiary eye centre in Nepal. A hospital-based cross-sectional study was conducted at the Department of Ophthalmology, Dhulikhel Hospital– Kathmandu University School of Medical Sciences, from 1 May to 1 July 2023. Following ethical approval, data were collected using a structured proforma from all patients with ptosis, covering demographic details, clinical history, ocular examination findings, eyelid measurements, associated conditions and visual acuity. Ptosis severity was assessed clinically and confirmed using marginal reflex distance. The study included 51 patients, with a mean age of 36.84 ± 21.16 years and 26 (51%) males. Ptosis was unilateral 26 (51%) and long-standing 33 (64.7%). No identifiable precipitating factor was found in 35 (68.6%) patients. Congenital ptosis was present in 7 (13.7%). The mean marginal reflex distance was 2.31 mm in the right eye and 2.04 mm in the left eye. Moderate to severe ptosis was observed in 28 (54.9%) patients. Visual impairment in the better eye was present in 13 (25.5%) patients, including 4 (7.8%) with severe visual impairment or blindness. Associated systemic or neuromuscular conditions were identified in 6 (11.8%) patients. Ptosis commonly presents as a unilateral, long-standing condition with a significant proportion of patients experiencing moderate to severe disease and visual impairment. Early detection and comprehensive evaluation are essential to optimize visual outcomes.