Q. I fear that my ptosis and strabismus cannot be corrected. Please help.

Answered by
Dr. Vaibhev Mittal
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 27, 2017 and last reviewed on: Oct 09, 2018

Hello doctor,

I am 26 years old. I am working in software field. I do have problems of ptosis and strabismus in my left eye since birth. I am not able to see with this eye until I forcefully close my right (dedicated) eye. I got operated for ptosis when I was 11, and it got recovered a lot. But, strabismus remains the same, and it affects my life a lot due to the cosmetic reason. I could not get socialized and try to avoid society. I had a lot of consultations with local doctors. Let me share my last meeting and my conclusion.

According to my local doctor, my upper lift muscle is dead by birth, and it cannot be restored ever. I have to stop thinking about fixing it. If surgery fixes it, then it will never appear as parallel as the right (dominant eye). Also, now my brain is receiving (single) right eye's image, and after surgery, my brain will receive two images. But, it will be difficult to focus on any of them. He also said that superior rectus muscle or inferior oblique muscle of left eye has stopped working or affected after my eyelid operation or those are dead by birth cause, and there is nothing to pull the eyeball upwards. The eyeball does not move and focus towards upwards and outwards.

Also, he mentioned about Brown syndrome. If this is a Brown syndrome, then the left lower eye that is affected, tethered or held down by the tight superior oblique tendon muscle. If this is true, then, in this case, the eye neither moves upward nor inwards towards the nose. But, my left eye moves inwards, but difficulty with moving outwards. Please clarify my doubts



Welcome to icliniq.com.

  • You have double elevator palsy. It is also known as monocular elevation deficit with ptosis.
  • You are right in saying that superior rectus and inferior oblique muscles are non-functioning. The only treatment is surgery.
  • We operate squint first, and Knapp surgery is required. Here, we transpose horizontal muscles (medial rectus and lateral rectus) to the inner and outer margin of superior rectus. This helps in decreasing hypotropia, and the eye movement is less affected.
  • We wait for six months to get a full effect of surgery, and then we operate lid for ptosis surgery (Tarsofrontalis sling) and it is the best option.
  • Sometimes, we can prescribe crutch glasses if the patient does not want ptosis surgery. So do not lose hope. Squint can be treated with your case, and ptosis surgery can be revised.

For further information consult an eye care ophthalmologist online --> https://www.icliniq.com/ask-a-doctor-online/eye-care-ophthalmologist

Was this answer helpful?


Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers

Can my diplopia be a sign of MS?

Query: Hello doctor, I am 23 years old female. Can you please explain to me the clinical presentation of decompensated phoria? I have had diplopia for over two years now, binocular, horizontal, worse on distant gaze. I have had an MRI as well, but no lesions found in my brain stem or other areas. Only a f...  Read Full »

Will my eyes look straight after squint surgery?

Query: Hi, I am 20 years old. Next month I am going to have my squint surgery for cosmetic purpose. I do not have vision in my right eye now and it turned inwards. After this surgery, will both my eyes look straight? Either I see left or right or up or down will both my eyes work together? How many hour...  Read Full »

My left upper eyelid is bigger than the right. How to rectify this?

Query: Hello doctor,My left upper eyelid is bigger than the right.  Read Full »

Also Read

I get twitches on my calves, shoulders, and head after getting the Novavax COVID vaccine. Please help.
Hello doctor, I got the Novavax COVID vaccine. Since I had the vaccine, I had bad arm pain. But the scary thing that ha...  Read more»
It hurts when I push above my left breast bone. Please help.
Hi doctor, I have been having some chest pain issues. When I push above my left breast bone it hurts in only one spot. ...  Read more»
Bird Flu (Avian Influenza) - Causes, Symptoms, Mortality Rate, and Treatment
Bird flu or avian influenza is a viral infection that spreads among birds and can affect humans rarely. Read the article...  Read more»

Ask your health query to a doctor online?

Ask an Eye Care Ophthalmologist Now

* guaranteed answer within 4 hours.

Disclaimer: All health Q&As published on this website are not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.