On Saturday Rita had her pediatric opthamologist appointment at the local children's hospital. As luck would turn out, the doctor we had the appointment with is same one who will do her surgery, and performs the most surgeries in the county for this condition (~2 per week out of ~3-4 total). So the appointment also doubled as per "pre-op" exam.

The diagnosis for Rita's congenital ptosis is that her levator muscle (muscle that controls the eyelid) did not develop properly. Normally if there is some function the surgery involves tightening/shortening of the muscle, but in Rita's case she will have a "frontalis sling" using a silicone implant. Basically what this means is that they will be attaching her eyelid to her eyebrow (with very small excisions) so that her eye stays open.

The surgery will take about an hour, and it will be under general anaesthetic. She will go home the same day, and recovery time is about 24 hours. The doctor said that if she was born in the USA the surgery would have been done when she was six months old.

Children with this condition can also have amblyopia (lazy eye), strabismus and/or need for eyeglasses. The doctor was surprised that her vision in her affected eye is almost perfect (this is rarely the case since patients typically favor the "normal" eye) but the doctor does suggest that she wear an eye patch for two hours a day to build up strength in the right eye.

After the surgery she will not have full function of the blinking mechanism. Apparently she will blink, but her eye won't be able to completely close. So this means when she is sleeping her eye will be partially open. Also, if she looks down her two eyelids may look different. But clearly this is no big deal compared to the positives (better appearance; and no further degeneration of her vision).

She may have to repeat the operation later in life if the implant doesn't hold up OR if she does something too rough and breaks the implant.

We are waiting to hear from the person who coordinates the surgery as to when it will take place. The doctor thought it would be early April but she has put us down as a special case (since Rita is a school aged child) and on the cancellation list.

Funny sidenote: We went for breakfast afterwards and when we went to the bathroom ('cause we need to visit every public bathroom!) Rita looked at herself in the mirror with confusion and said to me... "Mama it's still small - not big" (my translation)... We were at the doctor's office over two hours, with lots of poking and lights flashing in her eyes, so she thought that the doctor fixed her eye during the exam!