Tuesday, December 7, 2010

Disease of the Eyelid


DEF: Drooping of upper eyelid weakness or paralysis of the levator palpebrae superioris.


1. Bad cosmetic appearance of the drooping upper lid
2. Interference with vision: if pupillary area is covered -Amblyopia
3. Elevation of eyebrows & wrinkling of skin of forehead
4. Compensatory backword Head tilt -when condition is severe & bilateral
5. In marked ptosis -superior palpebral fissure is Absent
6. In paralytic ptosis -there may be partial or complete Ophthalmoplegia



* since birth & it usually hereditary or bilateral
* it may simple due to poor development or absent of levator musle
* Epicanthus,telecanthus & blepharo-phimosis -blepharo-phimosis syndrome


* Mechanical ptosis - due to increased weight of lid
e.g :multiple Chalazia,amyloid, hyaline degeneration
* Traumatic ptosis - mechanical effect of hge,edema,emphysema
-injury of levator ms
-traumatic scarring
* Neurogenic ptosis - levator ms paralysis due to 3rd nerve palsy
- Muller's ms paralysis due to sympathetic paralysis -as in Horner's syndrome
-Marcuss- Gunn syndrome (Jaw winking ptosis)
* Myogenic ptosis -Myasthenia Gravis
- Myotonic Dystropy
- Chronic progressive external ophthalmoplegia
* Hysterical ptosis - usually in young female with some emotional troubles
- may be unilateral or bilateral
-characterized by -trembling of ptotic lid
- behavior of patient
- no frowning of forehead
* Pseudo ptosis - due to loss of posterior support of upper lid
* Senile ptosis - primary weakness of levator ms or aponeurotic defefect

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