Abstract
Reverse ptosis is defined as an abnormally elevated lower eyelid with a decrease in the margin to corneal light reflex distance 2 (MRD2). Patients may present with functional or aesthetic concerns due to asymmetry, obscuration of the visual axis on downgaze, or decreased visual acuity due to astigmatism. Causes of reverse ptosis can be mechanical or neurologic. Treatment is typically surgical. Surgical approaches may include addressing globe position, or in the case of isolated lower eyelid dysfunction, advancement of the lower eyelid retractors or inferior tarsal muscle-conjunctivectomy. This chapter details etiology and treatments for reverse ptosis of the lower eyelid.