Impact of high myopia and duration of hard contact lens wear on the progression of ptosis

To investigate the impact of myopia and duration of hard contact lens (HCL) wear on the progression of ptosis. This study involved 194 eyes of 98 patients with either bilateral or unilateral ptosis with long-term HCL wear. The ptosis of each eyelid was classified into 1 of 4 grades (no ptosis, mild, moderate and severe), and the average spherical equivalent refractive error (SERE), patient age and the duration of HCL wear were then examined. The average SERE (in diopters) in 99 severe eyes was -8.34, in 47 moderate eyes, -6.28, in 37 mild eyes -5.57 and in 11 no ptosis eyes, -4.80, while the average duration of HCL wear (in years) were 34, 30, 29, and 31, respectively. The average SERE was significantly higher in the severe than in the moderate, mild and no ptosis eyelids, and the average duration of HCL wear was significantly longer in the severe than in the moderate and mild ptosis eyelids. Path analysis showed that the severity of ptosis is significantly influenced by SERE, as well as by patient age and the duration of HCL wear. High myopia, patient age and long-term HCL wear are risk factors associated with the progression of ptosis.