# Evaluation of pediatric patients presenting with acute-onset unilateral transient acquired blepharoptosis

## TL;DR

This study examines rare cases of sudden, one-sided drooping eyelid in children and finds that it often resolves on its own without surgery.

## Contribution

The study provides new insights into the natural resolution of acute-onset unilateral transient blepharoptosis in children.

## Key findings

- Trauma and infection were the most common causes of blepharoptosis in 16 pediatric patients.
- Most cases resolved spontaneously without surgery or long-term complications.
- Rare conditions like Miller Fisher syndrome and neuroblastoma were also identified as causes.

## Abstract

To evaluate the clinical features of pe diatric patients with acute-onset,
unilateral transient acquired blepharoptosis.

In this retrospective study, the clinical records of patients between April
2015 and June 2020 were reviewed for evaluation of demographic features,
accompanying neurological and ophthalmologic manifestations, symptom
duration, etiological cause, and imaging findings. Patients with congenital
and acquired blepharoptosis with chronic etiologies were excluded.

Sixteen pediatric patients (10 boys and 6 girls) with acquired acute-onset
unilateral transient blepharoptosis were included in this study. The
patients’ mean age was 6.93 ± 3.16 years. The most commonly
identified etiological cause was trauma in 7 patients (43.75%) and infection
(para-infection) in 5 patients (31.25%). In addition, Miller Fisher
syndrome, Horner syndrome secondary to neuroblastoma, acquired Brown’s
syndrome, and pseudotumor cerebri were identified as etiological causes in
one patient each. Additional ocular findings accompanied blepharoptosis in 7
patients (58.33%). Blepharoptosis spontaneously resolved, without treatment,
in all the patients, except those with Miller Fisher syndrome,
neuroblastoma, and pseudotumor cerebri. None of the patients required
surgical treatment and had ocular morbidities such as amblyopia.

This study demonstrated that acute-onset unilateral transient blepharoptosis,
which is rare in childhood, may regress without the need for surgical
treatment in the pediatric population. However, serious pathologies that
require treatment may present with blepharoptosis.