ptosis

Ptosis (Blepharoptosis)

Drooping of the upper eye lid is known as ptosis.

Causes:

(1)       Neurogenic,

(a)       3^rd nerve palsy

(b)       Horner’s synd

(c)        Marcus Gunn Jaw Winking Ph. shows retraction of the ptotic lid in conjunction with stimulation of ipsilateral pterygoid muscle.

(2)       Aponeurotic

Caused by a defect in aponeurosis which restricts the transmission of force from a normal levator muscle to lid

It may be

(a)       Involutional (age related)

(b)       Post operative

(c)        Bephrochalasis

caused by recurrent  oedema  of the upper lid - leads to potsis. Starts at puberty

3) Mechanical Ptosis.

            (a)       Dermatochalesis

Redundant upper lid skin which hangs below the upper lid margin. Causing pseudoptosis

(b)       Tumours

(c)        Oedema

(d)       Conj: Scarring

4)         Traumatic

5)         Myogenic

a)   Congential

b)   Acquired

(i)         Myasthenia Gravis   

(ii)        Ocular myopathies

(iii)       Myotonic dystrophy