Outcome of Fascia Lata Frontalis Sling Suspension in a Challenging Case of Post-traumatic Aponeurotic Ptosis with an Upgaze Limitation: A Case Report.

Ptosis is drooping of the upper lid margin in primary gaze, which can be broadly classified as congenital and acquired. Acquired ptosis is further classified as myogenic, aponeurotic, neurological, mechanical, and traumatic. Ptosis secondary to trauma is caused by heterogeneous mechanisms. It is usually associated with distorted anatomy, making the management challenging and outcomes unpredictable. We present the case of a 46-year-old male patient, diagnosed with right eye complete post-traumatic aponeurotic ptosis with fair Bell's and poor levator palpebrae superioris action, vertical dystopia, upgaze limitation, and upper lid scarring. He had difficulty in pursuing his occupation and maintaining a livelihood as complete ptosis led to the loss of binocularity and depth perception, which also led him to a high risk of occupational hazards. Therefore, we planned the patient's frontalis suspension procedure using autogenous fascia lata and the Crawford technique based on the risks and possible outcomes explained. Postoperatively, the patient's marginal reflex distance 1 (MRD 1) was 2 mm. The patient did not have any diplopia, achieved binocularity, and was satisfied with the results. He is managing well his day-to-day activities without any difficulty with depth perception.