Blepharoptosis - External and Internal Eye
The eyelid can droop for a variety of reasons: a dehiscence of the levator muscle from the structural tarsal plate, a mechanical growth or swelling, muscle weakness, a neurologic deficit, or trauma.
Blepharoptosis can be congenital or acquired. Congenital blepharoptosis is usually due to an embryologic failure of development or weakness of the levator muscle. Careful examination of young patients is important to exclude various syndromes such as Marcus Gunn jaw-winking syndrome.
The most common form of blepharoptosis presents in the elderly and is due to the dehiscence of the levator aponeurosis insertion. This disinsertion may be attributable to a stretching of tissues with age, or it is sometimes associated with trauma, such as previous eye surgery where an eyelid speculum was used. These patients often have an elevated lid crease with a gradual lowering of the resting eyelid position. The levator function is typically normal.
An acute onset of blepharoptosis associated with headache, pupillary dilation, or extraocular dysmotility is suggestive of cranial nerve involvement. Mild blepharoptosis associated with miosis of the ipsilateral eye indicates Horner syndrome, which affects the sympathetic pathway.
H02.409 – Unspecified ptosis of unspecified eyelid
11934000 – Ptosis of eyelid
Differential Diagnosis & Pitfalls
- Eyelid edema
- Brow ptosis
Drug Reaction Data