Purpose: To evaluate changes in tear condition following unilateral ptosis surgery.

Methods: In this case series all patients with unilateral ptosis who underwent ptosis surgery over a Two-year period were studied. The patients did not have history of previous eye surgery or other eye problems. Eyelid and lacrimal evaluation included Schirmer’s test with and without anesthesia and tear break up time (TBUT), which were performed before, and 1, 3, and 6 months after surgery. Ptosis surgery included levator resection and sling. Subjective symptoms related to dry eye were also evaluated before and after surgery.

Results: Overall, 83 patients with mean age of 26.2±16.2 years including 46 (55.4%) male patients were studied. The most common cause of ptosis was congenital in 77 (92.8%) patients. Surgical procedure was levator resection in 56 (675%) cases and sling in 27 (32.5%) cases. The result of surgery was good in 47 (56.6%) patients but we noted under-correction in 32 (39.8%) and over-correction in 3 (3.6%) patients. The changes in the Schirmer’s test with and without anesthesia and in TBUT after the surgery were in favor of decrease in tear quantity and quality after operation with time. Patients who had complaints of dryness had only shorter TBUT among the objective signs. Above-mentioned indices were not significantly different based different types & results of surgery.

Conclusion: Ptosis surgery can potentially decrease the quantity and quality of tear in operated eyes and may lead to overt signs and symptoms of dry eye. Considering that some of these patients may need other ocular surgeries in future such as refractive or cataract surgeries, evaluation of the tear condition before surgery is prudent.