DDx
Differential Diagnoses
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Horner Syndrome
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Lyme Disease
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Neuro-ophthalmic History
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Ophthalmologic Manifestations of Neurofibromatosis Type 1 (NF-1)
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Thyroid Ophthalmopathy
Media Gallery
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Patient with bilateral ptosis before surgery. Note the high lid creases.
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Same patient as in the previous image after bilateral internal levator advancement. No skin incision was made, and no crease reformation was performed.
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Anterior approach to the levator. White band is the levator aponeurosis (arrow).
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Left ptosis. Lid crease is absent on the left. The crease is up in the sulcus. Superior sulcus deformity is present on the left and right, and the patient is elevating her brows. The right upper lid should be checked for an underlying or masked ptosis. If the right lid is ptotic, lifting the left lid causes the right lid to droop.
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Visual field shows functional blockage of superior visual field due to a ptotic lid. Hashed line represents the superior extent of the seen visual field with the lid lifted. Solid line is with the lid in its natural, ptotic position.
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Congenital ptosis on right. Note the presence of a lid crease.
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Glasses with a crutch attached (arrow) that can be used to lift the lid if the patient does not desire surgery.
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Patient with myasthenia gravis. Right lid is more ptotic than the left lid.
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Same patient as in the previous image, 3 months later. Note how the ptosis has changed and is more on the left than the right.
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Patient with bilateral ptosis before surgery.
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Same patient as in the previous image after internal levator advancement. Patient has excessive skin (dermatochalasia) after the lid was lifted, with a pseudoptotic effect more on the left than the right. The dermatochalasia was present before surgery but is more significant afterward. Patient also has brow ptosis.
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