Ptosis

Question 1

What are the congenital causes of ptosis?

Answer 1

• Blepharophimosis
• Congenital CN3 palsy
• Marcus Gunn jaw winking syndrome
• Congenital Horner syndrom

Question 2

what are the mechanical acquired cause of ptosis?

Answer 2

• Eyelid tumours
• Eyelid oedema (e.g. allergic reaction, peri-orbital trauma, severe ocular infection, e.g. orbital cellulitis or endophthalmitis
• Aponeurotic (dehiscence of LPS aponeurosis) (ptosis w/o diplopia): Age related (i.e. involutional), post op, contact lens use

Question 3

what are the myogenic acquired cause of ptosis?

Answer 3

• Myasthenia gravis (MG)
• Senile (MOST COMMON)
• Myotonic dystrophy

Question 4

what are the neurogenic acquired cause of ptosis?

Answer 4

• CN3 palsy

- Horner syndrome (usually unilateral)

Question 5

what are the differentials of ptosis (i.e. psuedo ptosis)?

Answer 5

• Contralateral proptosis, contralateral lid retraction e.g. thyroid eye disease
• Ipsilateral enophthalmos (i.e. decreased orbital volume
• Ipsilateral hypotropia
• Brow ptosis
• Dermatochalasis (excessive upper eyelid skin overhanding the lid margin; usually bilateral and 2’ to ageing)