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—We thank Small for defining ptosis and also for pointing out that his study demonstrated superior field defects in 97% of patients with a midpupil to upper lid distance of less than 2 mm.He further describes semantic problems such as the use of the term cosmetic in describing operating procedures and in ophthalmic literature. He makes an important distinction between cosmetic and reconstructive surgery. Unfortunately, our literature has referred to many problems that do not interfere with vision as "cosmetic." However, physicians should not refer to a problem as cosmetic in their charts or referral letters, for example, "I am referring you this patient with a cosmetic ptosis." If an insurance company receives such information in a second opinion or in requested records, the surgery will not be covered, regardless of what other information is provided. Therefore, it is important to avoid the term cosmetic and supplant
Anderson RL, Holds JB. Functional vs Cosmetic Ophthalmologic Defects-Reply. Arch Ophthalmol. 1991;109(9):1194-1195. doi:10.1001/archopht.1991.01080090016004