Congenital Ptosis - 5 Year Old Boy

5 yr old boy with right congenital ptosis. Vision is ok but field of vision is less. He has fold. Sometimes the eye "opens" more. Concerned with right eye looking smaller and position of pupil, e.g. camera flash is only noticeable on left eye. What kind of surgery is needed to repair? If more than one choice of surgery, what is best? Need names of EXCELLENT pediatric occuloplastic surgeons in CT/MA/NY. What is best age for child to have surgery to avoid need for repeat surgery in future? Thanks.

Doctor Answers 1

You need to have a pediatric ophthalmologist close to home.

It is important to understand that your son will benefit from an ongoing assessment and follow up not by a general ophthalmologist but by a pediatric ophthalmologist irrespective of what surgery might be in his future.  The primary issue is amblyopia.  He appears in the photo to fix with the eye with the heavy lid but this can be only precisely assessed by an actual examination.  Regarding of the timing of eyelid surgery, this needs to be individualized.  If the heavy lid is impacting vision, then earlier surgery will be indicated.  If the vision is not impact then one has the luxury of waiting and allowing him to grow before making a surgical intervention.  Only the examining specialist can make this assessment.  Please be aware that in his lifetime he may need more than one surgery to address this situation.  Regarding names, the area you live in is blessed with many great specialists.  To name a few in no particular order, there is Daniel Salchow, MD. at Yale, Aaron Fay, M.D. at Massachusetts Eye and Ear Infirmary, and Michael Kazim, M.D. at Columbia.  There are literally dozens and dozens more in your area who are qualified to assess and treat your son.

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