Congenital Ptosis Workup

  • Author: Donny W Suh, MD, FAAP; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Mar 9, 2012
 

Laboratory Studies

If myasthenia gravis is suspected, check serum acetylcholine receptor antibody levels.[3]

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Imaging Studies

The following are indications to perform neuroimaging studies (eg, MRI, CT) of the orbit and brain:

  • History not consistent and onset not clear
  • Other neurologic findings along with ptosis
  • Orbital wall fracture suspected with history of trauma
  • Visible or palpable lid mass
  • Orbital tumors (eg, lymphoma, leukemia, rhabdomyosarcoma) suspected
  • New onset of Horner syndrome with or without other neurologic findings
  • New onset of third cranial nerve palsy with or without other neurologic findings
  • Globe displacement with either enophthalmos or proptosis
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Other Tests

If myasthenia gravis is suspected, the following tests are recommended:

  • Single fiber electromyography (EMG)
  • Tensilon test
  • Ice test

If a mitochondrial disorder is suspected, an ECG is recommended.

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Procedures

If a mitochondrial disorder is suspected, a muscle biopsy should be performed.

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Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Donny W Suh, MD, FAAP  Clinical Assistant Professor, Pediatric Ophthalmology Service, University of Nebraska Medical Center; Pediatric Ophthalmologist, Adult Strabismus Specialist, Wolfe Eye Clinic, PC; Consulting Staff, Blank Children's Hospital, Mercy Medical Center of Des Moines, Iowa Methodist Hospital of Des Moines, and Marshalltown Medical Center

Donny W Suh, MD, FAAP is a member of the following medical societies: American Academy of Ophthalmology, American Academy of Pediatrics, and American Medical Association

Disclosure: Alcon Honoraria Speaking and teaching

Specialty Editor Board

Michael J Bartiss, OD, MD  Medical Director, Ophthalmology, Family Eye Care of the Carolinas

Michael J Bartiss, OD, MD is a member of the following medical societies: American Academy of Ophthalmology, American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, and North Carolina Medical Society

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Mark T Duffy, MD, PhD  Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal and Reconstructive Surgery, Green Bay Eye Clinic, BayCare Clinic; Medical Director, Advanced Cosmetic Solutions, A BayCare Clinic

Mark T Duffy, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Sigma Xi, and Society for Neuroscience

Disclosure: Allergan - Botox Cosmetic Honoraria Speaking and teaching

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

I would like to thank my family for their patience and unremitting support.

References

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  13. Salour H, Aletaha M, Bagheri A. Comparison of Mersilene mesh and autogenous fascia lata in correction of congenital blepharoptosis: a randomized clinical trial. Eur J Ophthalmol. Nov-Dec 2008;18(6):853-7. [Medline].

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  16. Malone TJ, Nerad JA. The surgical treatment of blepharoptosis in oculomotor nerve palsy. Am J Ophthalmol. Jan 15 1988;105(1):57-64. [Medline].

  17. Meyer DR, Rheeman CH. Downgaze eyelid position in patients with blepharoptosis. Ophthalmology. Oct 1995;102(10):1517-23. [Medline].

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Chin-up posture due to congenital ptosis of the left eye.
Congenital ptosis of the left eye partially obstructing the left pupillary axis.
Congenital ptosis of the right eye.
 
 
 
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