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

ABSTRACT Purpose: To evaluate the clinical features of pediatric patients with acute-onset, unilateral transient acquired blepharoptosis. Methods: 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. Results: 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. Conclusion: 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.

摘要
目的：评估急性起病、单侧暂时性获得性上睑下垂（blepharoptosis）儿科患者的临床特征。
方法：本项回顾性研究对2015年4月至2020年6月期间的患者临床记录进行回顾，分析其人口统计学特征、伴随的神经与眼科表现、症状持续时间、病因及影像学表现，排除先天性及慢性病因获得性上睑下垂患者。
结果：本研究共纳入16例急性起病单侧暂时性获得性上睑下垂儿科患者，其中男10例、女6例，平均年龄为6.93±3.16岁。最常见的病因分别为外伤（7例，占43.75%）与感染（副感染（para-infection），5例，占31.25%）；此外，米勒费希尔综合征（Miller Fisher syndrome）、神经母细胞瘤继发霍纳综合征（Horner syndrome）、获得性布朗综合征（Brown’s syndrome）及假脑瘤（pseudotumor cerebri）各有1例患者。7例患者（58.33%）伴有其他眼部表现。除米勒费希尔综合征、神经母细胞瘤及假脑瘤患者外，其余所有患者均未经治疗即自行缓解，无一例患者需要手术治疗或出现弱视等眼部并发症。
结论：本研究证实，儿童时期较为罕见的急性起病单侧暂时性获得性上睑下垂，在儿科人群中可自行消退，无需手术干预。但需注意，需接受治疗的严重病变亦可表现为上睑下垂。