Congenital Ptosis (Drooping Eyelid) Workup

Updated: May 21, 2019
  • Author: Donny W Suh, MD, FAAP; Chief Editor: Edsel B Ing, MD, MPH, FRCSC  more...
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Workup

Laboratory Studies

If myasthenia gravis is suspected, check serum acetylcholine receptor antibody levels. [6]

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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, sleep ice test, edrophonium testing, and single-fiber electromyography can be considered.

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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