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June 1996

Loss of Vertical Palpebral Fissure Height on Downgaze in Acquired Blepharoptosis-Reply

Author Affiliations

Norwalk, Conn
Chicago, Ill

Arch Ophthalmol. 1996;114(6):774. doi:10.1001/archopht.1996.01100130766035

In reply  Dr Wojno is correct. Our article1 refers to Dr Patipa's commentary included in Dr Wojno's article.2 He asks, "Are these patients using their eyebrows in primary gaze to elevate their eyelids, but are unable to use their frontalis muscle for upper eyelid elevation in downgaze?" In our prospective study,1 we quantified the extent to which patients enlist their frontalis muscle in downgaze and demonstrated that frontalis muscle fatigue can contribute to asthenopic symptoms in downgaze ptosis.We would also like to correct a footnote in the previous paragraph of our article. We state: "Our findings support those of other investigators who have identified downgaze ptosis as a functional problem.3,4,13" The reference to footnote 13 should instead indicate footnote 14, which lists Dr Wojno's article. Our article is an edited version of a lengthier thesis and unfortunately the original reference ended up on the cutting

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