Reversal of inverse Bell’s reflex after sling removal and scar lysis in an 11-year-old patient: a case report


  • Cheuk Ling Yim Hong Kong Eye Hospital
  • Tracy YT Kwok Hong Kong Eye Hospital
  • Hunter KL Yuen Hong Kong Eye Hospital


Blinking, Eyelid diseases, Keratitis, Reflex


We report a case of inverse Bell’s reflex of the right eye in an 11-year-old boy who underwent frontalis suspension ptosis correction at the age of 1 year and developed scarring secondary to exposure and infection of the sling implant 5 months later. At the age of 11 years, the patient had an episode of right eye infective keratitis secondary to corneal exposure and was first noted to have developed the inverse Bell’s reflex. The patient underwent removal of sling, scar lysis, and limited full thickness blepharotomy. At postoperative 11 months, the Bell’s reflex was completely normal. This suggests that eyelid scar tissue may contribute to the development of inverse Bell’s reflex and that scar lysis, despite delayed, may resolve the problem.


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How to Cite

Yim CL, Kwok TY, Yuen HK. Reversal of inverse Bell’s reflex after sling removal and scar lysis in an 11-year-old patient: a case report. Hong Kong J Ophthalmol [Internet]. 2022Dec.29 [cited 2023Feb.3];26(2). Available from:



Case Report