You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A 3 year old child is presenting with drooping of upper lid since bih. On examination , the palpebral apeure height is 6 mm and with poor levator palpebrae superioris function. What is the procedure recommended and explain in detail?
Ptosis: - * Ptosis or blepharoptosis ( Greek - to fall ) is the drooping of the upper eyelid to a level that covers more than 2mm of the superior cornea. Classification:- Congenital:- * Simple * Associated with Superior Rectus weakness * Associated with Marcus Gun Jaw Winking phenomenon Acquired:- * Neurogenic - III Cn palsy , Horner's syndrome * Myogenic - myasthenia gravis, ocular myopathy, senile * Mechanical - excess weight due to edema, tumors * Traumatic - trauma to levator palpebrae Management :- TREAT the systemic cause Mild Ptosis:- * Mullerectomy --> Muller muscle resection for 1mm ptosis ( HORNER'S SYNDROME) * Fasanella Servat operation -->simple tarsoconjunctival resection Moderate Ptosis:- * With fair - good levator function --> LEVATOR RESECTION Severe Ptosis with Poor Lps Function:- * BROW SUSPENSION / FRONTALIS SLING SURGERY where Lids are attached to the frontalis muscle with a silicon tube. So with the contraction of frontalis , lids elevate. Ref:- A K Khurana Comprehensive Ophthalmology 7th edition; pg num:- 395