Simple or dysgenetic myopathic ptosis presents in early childhood and results from a primary developmental defect in the levator muscle and replacement of muscle tissue by fibrous and fatty tissue. The eyelid margin can transect the pupil so the child often assumes a chin-up position to improve the visual field.  If vision is significantly blocked, amblyopia may result. Levator muscle function is typically reduced due to fibrosis. In cases with good muscle function repair is achieved by shortening the levator aponeurosis. But when muscle function is minimal or absent, frontalis suspension may be the only alternative by linking the eyelid to the brow with a silicone rod or fascia lata.