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Can surgery correct the jaw winking phenomenon?

Dr Arun Mishra
Consultant Ophthalmic Surgeon, UK

Q: My daughter is 6 years old and since she was 2 years old we noticed that her eye ball movement in one eye is not normal in comparison to the other. It goes in more towards the inside when she focuses her eye on something. The eye sight is normal, she does not have a squint. We have had the refraction done and the doctors suggested it to be a jaw winking phenomenon. Is there any exercise or surgery that can help correct it?

A:Jaw winking phenomena is caused by abnormal wiring of the nerves from the brain, in which there is drooping of the upper eyelid in the affected eye and when the jaw moves while chewing anything, the drooping eyelid moves up and down with chewing movement.This is present since birth and nothing needs to be done. It does not affect the eye sight ever and at most it could be a cosmetic embarrassment. Imagine wrong wiring in which fan runs instead of light turning on when light switch is pressed and vice versa. Similarly, the nerve to the eyelid goes to muscle of mastication and vice versa.If you do want surgery for it then it is possible to cut the nerve which moves the eyelid up and down and then correct the subsequent drooping of the eye lid by surgery, however I would not advise surgery as it may not be 100% successful and there are chances of complications.