Part of our complete guide to Ptosis (Droopy Eyelid) — this page covers Marcus Gunn jaw-wink ptosis in depth.
Marcus Gunn Jaw Wink
Marcus Gunn jaw-wink ptosis is an example of synkinesis — an abnormal neural connection between two muscle groups that are normally unrelated. A branch of the trigeminal nerve (CN V, which supplies the pterygoid jaw muscles) misdirects into the branch of the oculomotor nerve (CN III) that lifts the upper eyelid. The result: the ptotic lid rises whenever the jaw opens or moves laterally.
Use the slider in the animation above to simulate the jaw-wink synkinesis — the eyelid rising as the jaw opens.
Key Features
- Occurs in 2–13% of patients with congenital ptosis
- Levator function is typically poor (≤ 4 mm)
- Does not improve spontaneously, though children learn to minimize visible jaw movement over time
- Associated strabismus in ≈ 60%, amblyopia in ≈ 35%
Treatment
The surgical approach is guided by the severity of both the ptosis and the jaw-wink:
- Mild jaw-wink with significant ptosis: unilateral frontalis sling may achieve acceptable symmetry
- Significant jaw-wink: bilateral levator muscle disinsertion followed by bilateral frontalis sling — this is intended to abolish the visible wink and allow more symmetric correction
Marcus Gunn jaw-wink is one of several congenital eyelid and orbital conditions present from birth.
Your Surgeon
Kathleen M. Duerksen, MD, FACS
Cosmetic and Reconstructive Surgery of the Eyelids, Orbits and Tear Ducts
🏅 ASOPRS Fellowship Trained