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Jaw-winking syndrome

Last edited: 4/15/2026

Overview

Marcus Gunn jaw-winking syndrome (MGJWS) is a congenital condition characterized by involuntary elevation of the upper eyelid (ptosis) when the jaw is opened, often associated with unilateral involvement and typically affecting one eye 1.

Diagnosis

  • Clinical Presentation: Involuntary ptosis with jaw movement (jaw-winking phenomenon) 1.
  • Physical Examination: Detailed ocular motility and ptosis assessment 1.
  • Grading: Severity of ptosis can be assessed using standardized scales like the Oxford Eye Examination for Children 1.

    • Management

  • Observation and Habituation: Early habituation of ptosis control with jaw positioning can occur, particularly in neonates 1.
  • Surgical Intervention: Considered for severe cases with persistent ptosis; surgery can be deferred until safer developmental stages to avoid amblyopia risk 1.

    • Special Populations

  • Pediatrics: Early habituation observed in neonates suggests potential for non-surgical management in infants 1.

    • Key Recommendations

  • Delay surgical intervention in severe MGJWS until safer developmental stages to minimize amblyopia risk (Evidence: Moderate) 1
  • Monitor and encourage habituation techniques in neonates with severe ptosis, as early control may be achievable 1 (Evidence: Weak)
  • Regular follow-up is essential to assess for signs of amblyopia development in affected eyes 1 (Evidence: Expert opinion)

    • References

    1 Lelli GJ, Nelson CC. Early habituation of severe blepharoptosis in marcus gunn jaw-winking syndrome. Journal of pediatric ophthalmology and strabismus 2006. link

    Original source

    1. [1]
      Early habituation of severe blepharoptosis in marcus gunn jaw-winking syndrome. — Lelli GJ, Nelson CC Journal of pediatric ophthalmology and strabismus (2006)
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