PMC6826180_01
Preoperative photograph (top) and postoperative (day 2) photograph after frontalis sling-suspension surgery (bottom).
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A 9-year old male presented with a history of drooping of the right upper lid since childhood with visual acuity of 6/6 (Snellen chart) in both eyes (Figure 1, top). There was overcorrection of the ptosis by 1 mm in primary gaze with mild lid edema and prominent lagophthalmos (Figure 1, bottom).
Postoperative (day 2) photograph showing inversion of Bell's phenomenon in both eyes following right frontalis sling-suspension surgery.
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Inverse Bell's phenomenon (downward rolling of the eyeball) was noted during eyelid closure (Figure 2).
Postoperative (day 22) photograph of the patient (top) and showing reversal to normal Bell's phenomenon in both eyes (bottom).
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At the 3-week postoperative visit, vertical palpebral fissure height was 11 mm in both eyes, with minimal lagophthalmos in the right eye (Figure 3, top). It had became normal (upward and outward), without any evidence of exposure keratopathy (Figure 3, bottom).