the levator muscle strength determination Suppress thumb to supraorbital eyebrows to exclude levator role of frontalis muscle.Ask the patient gaze down, put a millimeter ruler in front of the face, zero point alignment on the lid margin, and the patient is then asked to look up as far as possible, the lid margin increase from the bottom up.Measure from extreme downward gaze to extreme upward gaze while immobilizing the brow, more than 10 mm is good, 5-10 mm is fair, and the poor is less than 5 mm. the superior rectus function test The patient is asked to rotate eyeballs in all directions, and then close their eyes.Make eyelids open with your fingers to check whether the eyeballs rotate upward.If there is no turn, compared to the lack of Bellphenomenon, and it is not appropriate for ptosis corrective surgery because of posterative exposure keratitis possibility.If surgery is necessary, the amount of correction should be conservative as far as possible, to reduce or eliminate lagophthalmos. exclude myasthenia gravis For blepharoptosis patients with Honer syndrome, as well as Marcus Gunn's jaw- winking syndrome, levator muscle should first be cut off and then correct the drooping, or else the symptoms would aggravate.
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