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Associated morbidity of pediatric ptosis — a large, community based case–control study

  • Oculoplastics and Orbit
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To report the incidence, demographics, and associations of various conditions among patients with pediatric ptosis.

Methods

A retrospective, observational case–control study of patients (birth–18 years; n = 2,408) diagnosed with pediatric ptosis in 1/2003–12/2012. Age- and gender-matched control patients (n = 9,632) were randomly selected from the district members. Medical and socio-demographic information were extracted from electronic medical records.

Results

The average age of diagnosis was 5.6 years, and 1,325 (54 %) were male, with an incidence of 19.9/100,000. Systemic conditions significantly associated with pediatric ptosis include myasthenia gravis, congenital anomalies, deafness, mental retardation, muscular dystrophy, neurological diseases, epilepsy, schizophrenia, and malignancy.

Ophthalmic conditions associated with pediatric ptosis include exotropia, progressive external ophthalmoplegia, hypotropia, esotropia, hyperopia, vertical heterophoria, intermitent esotropia, astigmatism, retinopathy, internuclear ophthalmoplegia, and myopia. Symptoms of diplopia, blurred vision, and aniseikonia were significantly more common.

Conclusion

Pediatric ptosis is associated with various systemic and ophthalmic conditions, and many are diagnosed after the age of 5 years. Clinicians should maintain a high degree of suspicion and thoroughly evaluate all patients with pediatric ptosis to properly assess underlying systemic associations. A better understanding of the patho-physiological association between these factors and pediatric ptosis may help its prevention and treatment.

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Financial support

None

Financial disclosures

The authors have no financial interest in any of the materials used in this study. No conflicting relationship exists for any author.

Contributions of authors

Design and conduct of the study (YAN); data collection, management, analysis, and interpretation (SV); preparation, review, and approval of the manuscript (YAN): literature search and critical review. (YAN).

Dr Arie Nemet had full access to all study data, and takes responsibility for the integrity of the data and the accuracy of the data analysis. The manuscript was edited by Faye Schreiber, MS.

Both authors have read and approved the manuscript.

Conflicting interest

No conflicting relationship exists for any author.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Meir Medical Center, Kfar Saba, 4428164, Israel

    Arie Y. Nemet, Ori Segal & Michael Mimouni

  2. Office Central Headquarters, Clalit Health Services, Tel Aviv, Israel

    Shlomo Vinker

  3. Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Shlomo Vinker

Authors
  1. Arie Y. Nemet
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  2. Ori Segal
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  3. Michael Mimouni
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  4. Shlomo Vinker
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Correspondence to Arie Y. Nemet.

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Nemet, A.Y., Segal, O., Mimouni, M. et al. Associated morbidity of pediatric ptosis — a large, community based case–control study. Graefes Arch Clin Exp Ophthalmol 252, 1509–1514 (2014). https://doi.org/10.1007/s00417-014-2759-3

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  • DOI: https://doi.org/10.1007/s00417-014-2759-3

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