Purpose To report the prevalence and causes of strabismus in children with eyelid ptosis diagnosed in a well-defined population over a 40-year period. Design Retrospective, population-based cohort study. Methods We retrospectively reviewed the charts of 107 patients (<19 years) for the prevalence and causes of strabismus in children who were diagnosed with childhood eyelid ptosis as residents of Olmsted County, Minnesota, from January 1, 1965, through December 31, 2004. Results Strabismus was diagnosed in 20 (18.7%) of the 107 patients with childhood ptosis. Of the 81 patients, 8 (9.9%) were diagnosed with simple congenital ptosis and had strabismus, of which there were 4 (4.9%) cases of exotropia and 4 (4.9%) cases of esotropia. There were no cases of isolated vertical deviation. Conclusions Strabismus occurred in 1 of 5 children diagnosed with any form of childhood ptosis in this population-based cohort. Strabismus affected approximately 1 of 10 patients diagnosed with simple congenital ptosis, and a predominance of isolated horizontal deviations was equally divided between esotropia and exotropia.
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