Abstract：
OBJECTIVE: To report the method to assess belpahroptosis and its reliability of adult ptosis using video consultation.
METHODS: This is a retrospective, comparative, case series. The surgical waiting list for ptosis surgery between 8/2020 and 1/2021 was checked and only cases listed for surgery via video consultation assessment, without any previous face-to-face consultation, were included. The following data were collected for patients who underwent video consultation before surgery: Demographic data, level of experience of clinician, levator function, Cogan\'s twitch sign, fatigability test, eye motility, presence of lagophthalmos, clinical history to rule out Myasthenia Gravis, other myopathies or Horner syndrome, whether the surgery was performed or canceled, reason for cancellation, date of surgery, type of procedure and surgeon experience.
RESULTS: A total of 176 patients underwent ptosis surgery. From those, 45 patients (25.6%) had only video assessment prior to surgery, 36 patients (80%) eventually underwent ptosis surgery. Surgery was canceled in 20% of the cases: in 2 cases (4.44%) due to misdiagnosis of ptosis during video consultation, confirmed on the day of surgery during pre-surgical face-to-face assessment; the other 7 cases (15.55%) belpharoptosis was confirmed on face-to-face examination but the surgery was canceled due to other reasons. The diagnosis of ptosis assessment via video consultation was corrected in 43 cases (95%) (p_value = 0.156, chi_ square). The accuracy of ptosis diagnosis was 13 out of 15 (86.7%) by fellow assessments and 30 out of 30 (100%) by consultant assessments (p_value = 0.041, chi_ square). In most of the cases ptosis assessment in video consultation included: rough judgment of levator function, eye motility and checking signs of lagophthalmos.
CONCLUSIONS: Video consultation is an efficient and reliable way to assess patients with ptosis, with 95% of reliability. Although a thorough ptosis assessment is advised, there was no difference between the accuracy of diagnosis on those who did not have the full suggested assessment.
METHODS: This is a retrospective, comparative, case series. The surgical waiting list for ptosis surgery between 8/2020 and 1/2021 was checked and only cases listed for surgery via video consultation assessment, without any previous face-to-face consultation, were included. The following data were collected for patients who underwent video consultation before surgery: Demographic data, level of experience of clinician, levator function, Cogan\'s twitch sign, fatigability test, eye motility, presence of lagophthalmos, clinical history to rule out Myasthenia Gravis, other myopathies or Horner syndrome, whether the surgery was performed or canceled, reason for cancellation, date of surgery, type of procedure and surgeon experience.
RESULTS: A total of 176 patients underwent ptosis surgery. From those, 45 patients (25.6%) had only video assessment prior to surgery, 36 patients (80%) eventually underwent ptosis surgery. Surgery was canceled in 20% of the cases: in 2 cases (4.44%) due to misdiagnosis of ptosis during video consultation, confirmed on the day of surgery during pre-surgical face-to-face assessment; the other 7 cases (15.55%) belpharoptosis was confirmed on face-to-face examination but the surgery was canceled due to other reasons. The diagnosis of ptosis assessment via video consultation was corrected in 43 cases (95%) (p_value = 0.156, chi_ square). The accuracy of ptosis diagnosis was 13 out of 15 (86.7%) by fellow assessments and 30 out of 30 (100%) by consultant assessments (p_value = 0.041, chi_ square). In most of the cases ptosis assessment in video consultation included: rough judgment of levator function, eye motility and checking signs of lagophthalmos.
CONCLUSIONS: Video consultation is an efficient and reliable way to assess patients with ptosis, with 95% of reliability. Although a thorough ptosis assessment is advised, there was no difference between the accuracy of diagnosis on those who did not have the full suggested assessment.
摘要：
目的：报告使用视频咨询评估成人上睑下垂的方法及其可靠性。
方法：这是一个回顾性研究，比较,案例系列。检查了2020年8月至2021年1月1日之间的上睑下垂手术的手术等待名单，仅通过视频咨询评估列出了手术病例。没有任何事先面对面的咨询，包括在内。收集了以下数据，用于在手术前接受视频咨询的患者：人口统计数据，临床医生的经验水平，提升机功能，科根的抽搐标志，疲劳试验,眼睛运动,存在眩光，临床病史排除重症肌无力,其他肌病或霍纳综合征，无论手术是进行还是取消，取消的原因,手术日期,手术类型和外科医生经验。
结果：共有176例患者接受了上睑下垂手术。从那些,45例患者（25.6%）在手术前只有视频评估，36例(80%)患者最终接受了上睑下垂手术。在20％的病例中取消了手术：在2例（4.44％）中，由于在视频会诊中误诊了上睑下垂，在术前面对面评估期间在手术当天证实;其他7例(15.55%)上睑下垂在面对面检查中得到证实,但由于其他原因手术被取消.43例（95％）（p值=0.156，卡方）通过视频咨询进行上睑下垂评估的诊断得到纠正。通过同伴评估，上睑下垂诊断的准确性为15个中的13个（86.7％），通过顾问评估（p值=0.041，卡方）为30个中的30个（100％）。在大多数情况下，视频咨询中的下垂评估包括：对提上肌功能的粗略判断，眼睛蠕动和检查眼的迹象。
结论：视频会诊是评估上睑下垂患者的有效和可靠的方法，95%的可靠性。尽管建议进行彻底的上睑下垂评估，没有完整建议评估的患者的诊断准确性没有差异.
方法：这是一个回顾性研究，比较,案例系列。检查了2020年8月至2021年1月1日之间的上睑下垂手术的手术等待名单，仅通过视频咨询评估列出了手术病例。没有任何事先面对面的咨询，包括在内。收集了以下数据，用于在手术前接受视频咨询的患者：人口统计数据，临床医生的经验水平，提升机功能，科根的抽搐标志，疲劳试验,眼睛运动,存在眩光，临床病史排除重症肌无力,其他肌病或霍纳综合征，无论手术是进行还是取消，取消的原因,手术日期,手术类型和外科医生经验。
结果：共有176例患者接受了上睑下垂手术。从那些,45例患者（25.6%）在手术前只有视频评估，36例(80%)患者最终接受了上睑下垂手术。在20％的病例中取消了手术：在2例（4.44％）中，由于在视频会诊中误诊了上睑下垂，在术前面对面评估期间在手术当天证实;其他7例(15.55%)上睑下垂在面对面检查中得到证实,但由于其他原因手术被取消.43例（95％）（p值=0.156，卡方）通过视频咨询进行上睑下垂评估的诊断得到纠正。通过同伴评估，上睑下垂诊断的准确性为15个中的13个（86.7％），通过顾问评估（p值=0.041，卡方）为30个中的30个（100％）。在大多数情况下，视频咨询中的下垂评估包括：对提上肌功能的粗略判断，眼睛蠕动和检查眼的迹象。
结论：视频会诊是评估上睑下垂患者的有效和可靠的方法，95%的可靠性。尽管建议进行彻底的上睑下垂评估，没有完整建议评估的患者的诊断准确性没有差异.
