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In Reply.—We thank Drs Kersten and Kulwin for their comments. Our article contained a description of the surgical technique for ptosis repair in conjunction with blepharoplasty, but, as we stated, "ophthalmologic consultation is recommended in the initial workup of all patients with ptosis. In this way, the degree and type of ptosis may be redocumented and any other ocular abnormalities may also be noted."
The main point of the authors' letter is that a test for ocular dominance should be included in the preoperative ophthalmologic evaluation of patients with ptosis. We would certainly agree with this recommendation. We have normally used the phenylephrine (Neo-Synephrine) test rather than the manual test they recommend. When phenylephrine eye drops are placed into the eye that is most ptotic, it will stimulate Müller's muscle, which will cause the ptotic lid to raise and unmask a ptosis on the contralateral side, if one is
LARRABEE WF, MILLAY DJ. Ptosis in Blepharoplasty Surgery-Reply. Arch Otolaryngol Head Neck Surg. 1990;116(1):109. doi:10.1001/archotol.1990.01870010112033
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