ALBALON (naphazoline hydrochloride ophthalmic solution, USP) 0.1% [package insert]. Lake Forest, IL: Akorn, Inc. Revised March 2011.
Ben Simon GJ, Lee S, Schwarcz RM, et al. Muller's muscle-conjunctival resection for correction of upper eyelid ptosis: relationship between phenylephrine testing and the amount of tissue resected with final eyelid position. Arch Facial Plast Surg. 2007;9:413-417.
Cahill KV, Bradley EA, Meyer DR, et al. Functional indications for upper eyelid ptosis and blepharoplasty surgery: a report by the American Academy of Ophthalmology. Ophthalmol. 2011;118:2510-2517.
Farber SE, Codner MA. Evaluation and management of acquired ptosis. Plast Aesthet Res. 2020;7:20.
FDA. IOPIDINE® 0.5% (apraclonidine ophthalmic solution) 0.5% label. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020258s026lbl.pdf. Accessed August 27, 2020.
Finsterer J. Ptosis: causes, presentation, and management. Aesthetic Plast Surg. 2003;27:193-204.
Grace Lee N, Lin LW, Mehta S, Freitag SK. Response to phenylephrine testing in upper eyelids with ptosis. Digit J Ophthalmol. 2015;21:1-12.
Griepentrog GJ, Diehl NN, Mohney BG. Incidence and demographics of childhood ptosis. Ophthalmology. 2011;118:1180-1183.
Ho SF, Morawski A, Sampath R, Burns J. Modified visual field test for ptosis surgery (Leicester Peripheral Field Test). Eye. 2011;25:365-369.
Hu DN. Prevalence and mode of inheritance of major genetic eye diseases in China. J Med Genet. 1987;24:584-588.
King M. Management of Ptosis. J Clin Aesthet Dermatol. 2016;9:E1-E4.
Koka K, Patel BC. Ptosis Correction. In: StatPearls. Treasure Island (FL): StatPearls Publishing; June 28, 2020.
Lim JM, Hou JH, Singa RM, et al. Relative incidence of blepharoptosis subtypes in an oculoplastics practice at a tertiary care center. Orbit. 2013;32:231-234
LUMIFY (brimonidine tartrate ophthalmic solution 0.2%) [prescribing information]. Bridgewater, NJ: Bausch + Lomb; Approved 1996. Revised November 2018.
Mendonça TB, Lummertz AP, Bocaccio FJ, et al. Effect of Low-Concentration, Nonmydriatic Selective Alpha-Adrenergic Agonist Eyedrops on Upper Eyelid Position. Dermatol Surg. 2017;43:270-274
Pao KY, Mancini R. Nonsurgical periocular rejuvenation: advanced cosmetic uses of neuromodulators and fillers. Curr Opin Ophthalmol. 2014;25:461-469.
Phenylephrine. US National Library of Medicine website. https://medlineplus.gov/druginfo/meds/a606008.html#side-effects. Updated August 15, 2018. Accessed August 27, 2020.
Richards, HS, Jenkinson E, Rumsey N, et al. The psychological well-being and appearance concerns of patients presenting with ptosis. Eye. 2014;28:296-302.
Silverstein S, Slonim C, Smyth-Medina R, et al. Long-term safety and ocular of oxymetazoline for the treatment of acquired blepharoptosis. Presented at: American Academy of Aesthetic Medicine (AAAM) Congress; November 8-10, 2019; Las Vegas, NV.
Sundaram H, Kiripolsky M. Nonsurgical rejuvenation of the upper eyelid and brow. Clin Plast Surg. 2013;40:55-76.
Wijemanne S, Vijayakumar D, Jankovic J. Apraclonidine in the treatment of ptosis. J Neurol Sci. 2017;376:129-132.

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Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

Faculty

Don Kikkawa, MD

Trude Kahn Hollander Chair of Ophthalmology
Vice-Chairman
Department of Ophthalmology
University of California San Diego
La Jolla, California

Disclosures

Disclosure: Don O. Kikkawa, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Horizon Therapeutics

Steven Silverstein, MD

Clinical Professor of Ophthalmology
Kansas City University of Medicine and Biomedical Sciences
Kansas City, Missouri

Disclosures

Disclosure: Steven Silverstein, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Osmotica
Received grants for clinical research from: Osmotica

Wendy Lee, MD

Professor of Clinical Ophthalmology and Dermatology
University of Miami Miller School of Medicine
Miami, Florida

Disclosures

Disclosure: Wendy W. Lee, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Allergan; Galderma; Horizon; Mallinckrodt; Solta; Vertical/Osmotica

Editors

Pakinam Aboulsaoud, PharmD

Medical Education Director, Medscape, LLC

Disclosures

Disclosure: Pakinam Aboulsaoud, PharmD, has disclosed no relevant financial relationships.

Yoji Yamaguchi, MA

Associate Scientific Content Manager, Medscape, LLC

Disclosures

Disclosure: Yoji Yamaguchi, MA, has disclosed no relevant financial relationships.

CME Reviewer

Robert Morris, PharmD

Associate Director, Accreditation and Compliance , Medscape, LLC

Disclosures

Disclosure: Robert Morris, PharmD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: ViiV Healthcare
Owns stock, stock options, or bonds from: GlaxoSmithKline

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed the following relevant financial relationships:

Served as an advisor or consultant for: PRO-MAPP Health, Inc

CME

Fresh Perspectives: Topical Management of Blepharoptosis

Authors: Don O. Kikkawa, MD; Steven M. Silverstein, MD; Wendy W. Lee, MD
CME Released: 10/1/2020
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 10/1/2021, 11:59 PM EST

Start Activity

Target Audience and Goal Statement

This activity is intended for ophthalmologists, optometrists, dermatologists, and plastic surgeons and aesthetic medicine specialists.

The goals of this activity are to increase clinicians' knowledge of new topical treatment options for blepharoptosis and to identify patients who might benefit from a nonsurgical approach to restore function and appearance and thus improve quality of life.

Upon completion of this activity, participants will:

Have increased knowledge regarding the
- Patient assessment for blepharoptosis
- Emerging therapies for the management of blepharoptosis
- Treatment approaches for patients with blepharoptosis

Disclosures

Faculty

Don Kikkawa, MD

Trude Kahn Hollander Chair of Ophthalmology
Vice-Chairman
Department of Ophthalmology
University of California San Diego
La Jolla, California

Disclosures

Disclosure: Don O. Kikkawa, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Horizon Therapeutics

Steven Silverstein, MD

Clinical Professor of Ophthalmology
Kansas City University of Medicine and Biomedical Sciences
Kansas City, Missouri

Disclosures

Disclosure: Steven Silverstein, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Osmotica
Received grants for clinical research from: Osmotica

Wendy Lee, MD

Professor of Clinical Ophthalmology and Dermatology
University of Miami Miller School of Medicine
Miami, Florida

Disclosures

Disclosure: Wendy W. Lee, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Allergan; Galderma; Horizon; Mallinckrodt; Solta; Vertical/Osmotica

Editors

Pakinam Aboulsaoud, PharmD

Medical Education Director, Medscape, LLC

Disclosures

Disclosure: Pakinam Aboulsaoud, PharmD, has disclosed no relevant financial relationships.

Yoji Yamaguchi, MA

Associate Scientific Content Manager, Medscape, LLC

Disclosures

Disclosure: Yoji Yamaguchi, MA, has disclosed no relevant financial relationships.

CME Reviewer

Robert Morris, PharmD

Associate Director, Accreditation and Compliance , Medscape, LLC

Disclosures

Disclosure: Robert Morris, PharmD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: ViiV Healthcare
Owns stock, stock options, or bonds from: GlaxoSmithKline

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed the following relevant financial relationships:

Served as an advisor or consultant for: PRO-MAPP Health, Inc

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For Physicians

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From Medscape Education Ophthalmology

CME

Fresh Perspectives: Topical Management of Blepharoptosis

Authors: Don O. Kikkawa, MD; Steven M. Silverstein, MD; Wendy W. Lee, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME Released: 10/1/2020

Valid for credit through: 10/1/2021, 11:59 PM EST

processing....

Contents of This CME Activity

All sections of this activity are required for credit.

How to Assess the Patient With Blepharoptosis

Dr Kikkawa goes over the key steps to thoroughly assessing patients with blepharoptosis.
Don O. Kikkawa, MD

What Are the Options for Topical Therapy?

Dr Silverstein reviews the available nonsurgical treatment options for patients with blepharoptosis.
Steven M. Silverstein, MD

Who Should Receive Topical Therapy vs Surgery?

Drs Kikkawa and Lee discuss which patients with blepharoptosis are ideal candidates for nonsurgical therapy.
Don O. Kikkawa, MD and Wendy W. Lee, MD

Educational Impact Challenge

The goal of this activity is to increase clinicians' knowledge of new topical treatment options for blepharoptosis and identify patients who might benefit from a nonsurgical approach to restore function and appearance and thus improve quality of life.

Before you begin this activity, please assess your clinical knowledge by completing this brief survey. Answering these questions again after the activity will allow you to see what you learned and to compare your answers with those of your peers.

Page 1 of 6

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Disclaimer

The educational activity presented above may involve simulated, case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient, whether living or deceased, is intended or should be inferred. The material presented here does not necessarily reflect the views of Medscape, LLC, or any individuals or commercial entities that support companies that support educational programming on medscape.org. These materials may include discussion of therapeutic products that have not been approved by the US Food and Drug Administration, off-label uses of approved products, or data that were presented in abstract form. These data should be considered preliminary until published in a peer-reviewed journal. Readers should verify all information and data before treating patients or employing any therapies described in this or any educational activity. A qualified healthcare professional should be consulted before using any therapeutic product discussed herein.

References

Faculty and Disclosures

Faculty

Don Kikkawa, MD

Steven Silverstein, MD

Wendy Lee, MD

Editors

Pakinam Aboulsaoud, PharmD

Yoji Yamaguchi, MA

CME Reviewer

Robert Morris, PharmD

Peer Reviewer

CME

Fresh Perspectives: Topical Management of Blepharoptosis

Target Audience and Goal Statement

Disclosures

Faculty

Don Kikkawa, MD

Steven Silverstein, MD

Wendy Lee, MD

Editors

Pakinam Aboulsaoud, PharmD

Yoji Yamaguchi, MA

CME Reviewer

Robert Morris, PharmD

Peer Reviewer

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Fresh Perspectives: Topical Management of Blepharoptosis

Contents of This CME Activity

How to Assess the Patient With Blepharoptosis

What Are the Options for Topical Therapy?

Who Should Receive Topical Therapy vs Surgery?

Educational Impact Challenge