Blepharoptosis in myasthenia gravis.

We reviewed the records of 23 patients with systemic myasthenia gravis and blepharoptosis. The overall prognosis for improvement of blepharoptosis in these patients was favorable when multiple modes of therapy, including anticholinesterase medication, were used. Four of five patients with disabling blepharoptosis were stable enough after three to four years of their disease to consider corrective lid surgery. Two patients underwent levator resection with good results. Patients with systemic and ocular myasthenia gravis who are refractory to systemic therapy should be considered candidates for ptosis surgery when their blepharoptosis has been stable over a three- to four-year period.