Purpose
In patients referred with blepharoptosis, the possibility of an underlying systemic cause for their ptosis can warrant a more detailed evaluation. The purpose of this study is to determine both the incidence and demographic characteristics associated with different types of ptosis in patients referred to the oculoplastics division at a tertiary care center.
Methods
A retrospective chart review was performed on all patients referred to the oculoplastics division between 2007 and 2010. Final etiology for each patient’s ptosis was determined based on history, standard eyelid measurements, and ancillary testing. Based on etiology, ptosis was categorized as aponeurotic, neurogenic, myogenic, traumatic, or congenital. Demographics, including median age and sex were analyzed for patients in each category of ptosis.
Results
Of the 251 patients, aponeurotic ptosis was the most common type of ptosis (60.2%), followed by traumatic (11.2%), congenital (10.4%), mechanical (8.8%), neurogenic (5.6%), and myogenic (4.0%). Of the neurogenic group, 35.7% of patients had cranial nerve 3 (CN 3) palsy, 28.6% had myasthenia gravis, 14.3% had aberrant regeneration, and 7.1% had Horner’s syndrome. Thirty percent of the myogenic group had chronic progressive external ophthalmoplegia (CPEO). The congenital group had the youngest median age (10.5 years), yet the aponeurotic group had the oldest (62 years).
Conclusions
A significant proportion of patients referred with ptosis had more serious conditions such as neurogenic or myogenic ptosis. Thus, clinicians should maintain a high degree of suspicion and thoroughly evaluate all patients with ptosis in order to properly assess for underlying systemic associations.
This retrospective case series describes 7 eyes with KPros that underwent successful MMCR without compromise to the integrity of the KPro. Because these patients are at high risk for potential complications, we recommend careful patient selection, a goal of undercorrection, and consideration of supplemental procedures to the lower eyelids to minimize complications to the KPro.
A fifty-two-year-old female underwent a right frontotemporal craniotomy for microsurgical clip obliteration of a ruptured right dorsal variant ophthalmic segment carotid aneurysm. During the craniotomy, a defect involving the orbital roof was inadvertently created. The patient was noted postoperatively to have fluid egressing from her right eye. The fluid was analyzed and based on glucose and chloride levels was determined to be cerebrospinal fluid (CSF). Computed tomography (CT) scan of the head demonstrated the orbital roof defect created during surgery. After placement of a lumbar drain, fluid egress from the eye significantly decreased, further confirming the suspicion for CSF leak. Patient was found to have a conjunctival defect of the right eye, approximately 2.5 cm × 1.5 cm, extending to the fornix from 9 to 12 o'clock. The conjunctival defect and fornix was repaired with an amniotic membrane graft and a temporary tarsorrhaphy with subsequent resolution of CSF egress. The case report is in compliance with the Health Insurance Portability and Accountability Act.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.