superioris muscle was functioning normally.
For mild-to-moderate ptosis with levator function over 5 mm, various surgical procedures can be applied, such as the Muller muscle conjunctival resection, shortening of the levator palpebrae
, or levator muscle advancement.
c) Within the orbit the superior division of the nerve carries fibres for the levator palpebrae
and superior rectus muscles
The levator palpebrae
superioris, pupillary sphincter muscle, and four extraocular muscles (the superior rectus, inferior rectus, medial rectus, and inferior oblique muscles) are innervated by the oculomotor nerve.
It exists in complex with multiple independent subnuclei, controlling the superior, inferior, and medial rectus muscle, inferior oblique muscle, levator palpebrae
superioris muscle, and sphincter pupillae, respectively.
The normal adult upper lid is highest nasal to the pupil and covers 1-1.5 mm below the superior limbus.1,2 The basic etiology of ptosis is weakness of either of two elevators of the upper lid that include levator palpebrae
superioris and muller muscle.
After the posterior lamella is reconstructed, the levator palpebrae
is reinserted and stitched to the periosteum of the graft.
Instead of tarsorrhaphy or gold weight implants to protect the ocular surface in cases of facial paralysis, corneal damage may be prevented by using BoNT-A injection to the levator palpebrae
superioris muscle to induce eyelid ptosis.
The degree of ptosis, levator palpebrae
superioris function, age of the patient, and the condition of the cornea determine the choice of the surgical procedure.
The ptosis is mostly restricted to the levator palpebrae
and later involves other extraocular muscles.
It also innervates the levator palpebrae
superioris and carries with it the parasympathetic innervations to the pupil.
Lagophthalmos in non-leprosy patients is now commonly managed with upper lid closure augmentation procedures that provide a downward force on the upper lid when the levator palpebrae