Ptosis

Introduction Also known as "hanging down." Due to insufficiency or disappearance of the levator palpebral function, or some or all of the upper jaw can not be lifted, the upper jaw is in a drooping position. Divided into complete and partial, monocular or binocular, congenital and acquired, true and false.

Cause

Causes of drooping eyelids:

Can be congenital or acquired.

1 congenital: mainly due to oculomotor nucleus or levator dysplasia, is autosomal dominant inheritance.

2 acquired: due to oculomotor nerve paralysis, lifting diaphragmatic injury, sympathetic disease, myasthenia gravis and mechanical snoring movement disorders, such as inflammatory swelling or new organisms.

an examination

Related inspection

Eyelid examination ophthalmologic examination slit lamp

Eyelid drooping diagnosis:

If congenital, check whether: 1 simple ptosis (lifting or disappearing of the diaphragm function); 2 ptosis with upper rectus muscle function weakened; 3 ptosis with other ankle deformities, such as internal hemorrhoids Skin, etc.; 4 ptosis combined with (Marcus-Gunn) mandibular blinking movement phenomenon.

If the nature is acquired, check whether: 1 traumatic eyelid or craniocerebral injury, or cervical sympathetic nerve injury; 2 disease such as myasthenia gravis; 3 mechanical such as trachoma sacral infiltration, or loss of support force of eyelids, If there is no eyeball. When there is suspected myasthenia gravis, it can be used as a test for neostigmine. When it is suspected of sympathetic drooping, it can be used as a test for hydroxyamphetamine.

Differential diagnosis

Symptoms of eyelid sag that are confusing:

1. Eyelid relaxation: blepharochalasis syndrome, also known as dermatolysis palpebrarum, atrophic eyelid ptosis (ptosis atrophica), is a rare eyelid disease characterized by recurrent episodes of eyelid edema in adolescents The skin of the eyelids becomes thinner, the elasticity disappears, the wrinkles increase, the color changes, and the clinical manifestations of lacrimal gland prolapse, ptosis and shortening of the cleft palate can be complicated. In 1807, Beer first described the disease. In 1896, Fuchs called it eyelid retardation. Because the syndrome affects the appearance of the eyelids, it is the main reason for patients to require treatment. The understanding of their clinical manifestations and pathogenesis can help to adopt appropriate methods for treatment.

2. Eyelid valgus: Eyelid valgus is an abnormal state in which the rim of the eye leaves the eyeball and flips outward. The lighter is caused by the eyeball leaving, the severer is exposed to the conjunctiva, and even the eyelids are all everted.

At the same time, attention should also be paid to identifying congenital and acquired. If congenital, check whether: 1 simple ptosis (lifting or disappearing of the diaphragm function); 2 ptosis with upper rectus muscle function weakened; 3 ptosis with other ankle deformities, such as internal hemorrhoids Skin, etc.; 4 ptosis combined with (Marcus-Gunn) mandibular blinking movement phenomenon. If the nature is acquired, check whether: 1 traumatic eyelid or craniocerebral injury, or cervical sympathetic nerve injury; 2 disease such as myasthenia gravis; 3 mechanical such as trachoma sacral infiltration, or loss of support force of eyelids, If there is no eyeball. When there is suspected myasthenia gravis, it can be used as a test for neostigmine. When it is suspected of sympathetic drooping, it can be used as a test for hydroxyamphetamine.

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