Tests for Contralateral Pseudoretraction in Blepharoptosis

Pseudoretraction of the contralateral upper eyelid has long been recognized as a clinical phenomenon in certain patients with unilateral ptosis. In this prospective study of 30 patients with ptosis, we used two commonly used tests for pseudoretraction, the digital "lift" and "closure" tests. We also describe two new adaptations, the "lift and release" and "closure and release," which enhance these basic tests. The incidence of pseudoretraction in unilateral ptosis was found to be 66.7% and the test with the highest positive yield was the "closure test" (66.7%). The use of clinical tests for pseudoretraction, including the "release" maneuvers, are recommended as part of routine preoperative assessment of blepharoptosis.