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
**Core Concept**
The child's presentation is suggestive of congenital blepharoptosis, a condition characterized by drooping of the upper eyelid since birth. This condition is often associated with poor levator palpebrae superioris function, which is responsible for elevating the upper eyelid.
**Why the Correct Answer is Right**
The recommended procedure for congenital blepharoptosis is frontalis sling surgery. This surgical technique involves creating a sling using the frontalis muscle to elevate the drooping eyelid. The levator palpebrae superioris muscle is weak or absent in congenital blepharoptosis, making frontalis sling surgery a suitable alternative to address the eyelid drooping. The goal of the surgery is to improve the palpebral aperture height, which in this case is only 6 mm, indicating a significant drooping of the upper eyelid.
**Why Each Wrong Option is Incorrect**
* **Option A:** **Blepharoplasty** is a surgical procedure that involves removing excess skin and fat from the eyelids. While it may be used to correct eyelid drooping in adults, it is not the recommended procedure for congenital blepharoptosis in children.
* **Option B:** **Ptosis repair with levator resection** involves shortening the levator palpebrae superioris muscle to improve eyelid elevation. However, in congenital blepharoptosis, the levator muscle is often weak or absent, making this procedure less effective.
* **Option D:** **Eyelid taping** is a non-surgical method used to temporarily improve eyelid elevation. However, it is not a suitable long-term solution for congenital blepharoptosis.
**Clinical Pearl / High-Yield Fact**
In children with congenital blepharoptosis, it is essential to assess the levator palpebrae superioris function to determine the best course of treatment. A poor levator function is often associated with a more significant drooping of the upper eyelid and may require a more invasive surgical procedure like frontalis sling surgery.
**Correct Answer:** C. Frontalis sling surgery