Abstract
The surgical treatment of blepharoptosis is in most cases dependably effective and safe; by comparison, nonsurgical treatment generally provides less satisfactory results and can be difficult for the patient to tolerate. Therefore, relatively few patients will prefer medical treatment for symptomatic, chronic ptosis, except as a temporizing measure before a definitive procedure. The possible mechanisms for lifting the eyelid nonsurgically are external mechanical devices (skin-taping, adhesives, or spectacle-based lid crutches) to retract the upper lid, topical eye drops to stimulate Müller’s muscle, and injectable botulinum toxin to weaken orbicularis tone.
Keywords
- Botulinum Toxin
- Myotonic Dystrophy
- Contact Allergy
- Horner Syndrome
- Chronic Progressive External Ophthalmoplegia
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Mullaney PB, Nabi NU, Thorner P, Buncic R. Ophthalmic involvement as a presenting feature of nonorbital childhood parameningeal embryonal rhabdomyosarcoma. Ophthalmology. 2001;108(1):179–82.
Mohan S, Ahmed SI, Alao OA, Schliep TC. A case of AIDS associated cryptococcal meningitis with multiple cranial nerve neuropathies. Clin Neurol Neurosurg. 2006;108(6):610–3.
Sood BR, Sharma B, Kumar S, Gupta D, Sharma A. Facial palsy as first presentation of acute myeloid leukemia. Am J Hematol. 2003;74(3):200–1.
Miller MT, Strömland K. The Möbius sequence: a relook. J AAPOS. 1999;3(4):199–208.
Lapid O, Lapid-Gortzak R, Barr J, Rosenberg L. Eyelid crutches for ptosis: a forgotten solution. Plast Reconstr Surg. 2000;106(5):1213–4.
Morrison J. Ptosis spectacles. Med Techn Bull. 1951;2(2):41–3.
Lundie RNG. The Lundie Loop. Myasthenia Gravis Association. https://www.mga-charity.org/web/guest/the-lundie-loop.
Walsh G, Rafferty PR, Lapin J. A simple new method for the construction of a ptosis crutch. Ophthalmic Physiol Opt. 2006;26(4):404–7.
Jain V, Natarajan S, Shome D, Gadgil D. Spectacle-induced ocular trauma: an unusual mechanism. Cornea. 2007;26(1):109–10.
Suhonen R, Kanerva L. Allergic contact dermatitis caused by palladium on titanium spectacle frames. Contact Dermatitis. 2001;44(4):257–8.
Summer B, Fink U, Zeller R, Rueff F, Maier S, Roider G, et al. Patch test reactivity to a cobalt-chromium-molybdenum alloy and stainless steel in metal-allergic patients in correlation to the metal ion release. Contact Dermatitis. 2007;57(1):35–9.
Widman TJ, Oostman H, Storrs FJ. Allergic contact dermatitis from medical adhesive bandages in patients who report having a reaction to medical bandages. Dermatitis. 2008;19(1):32–7.
Marks Jr JG, Rainey MA. Cutaneous reactions to surgical preparations and dressings. Contact Dermatitis. 1984;10(1):1–5.
Osaki TH, Osaki MH, Belfort Jr R, Osaki T, Sant’anna AE, Haraguchi DK. Management of progressive myopathic blepharoptosis with daily application of octyl-2-cyanoacrylate liquid bandage. Ophthal Plast Reconstr Surg. 2009;25:264–6.
Garibaldi DC, Hindman HB, Grant MP, Iliff NT, Merbs SL. Effect of 0.5% apraclonidine on ptosis in Horner syndrome. Ophthal Plast Reconstr Surg. 2006;22(1):53–5.
Abdel-Latif AA, Akhtar RA, Zhou CJ. Effects of surgical sympathetic denervation on G-protein levels, alpha and beta-adrenergic receptors, cAMP production and adenylate cyclase activity in the smooth muscles of rabbit iris. Curr Eye Res. 1995;14(5):405–11.
Koc F, Kavuncu S, Kansu T, Acaroglu G, Firat E. The sensitivity and specificity of 0.5% apraclonidine in the diagnosis of oculosympathetic paresis. Br J Ophthalmol. 2005;89(11):1442–4.
Morales J, Brown SM, Abdul-Rahim AS, Crosson CE. Ocular effects of apraclonidine in Horner syndrome. Arch Ophthalmol. 2000;118(7):951–4.
Munden PM, Kardon RH, Denison C, Carter K. Palpebral fissure responses to topical adrenergic drugs. Am J Ophthalmol. 1991;111(6):706–10.
Scheinfeld N. The use of apraclonidine eyedrops to treat ptosis after the administration of botulinum toxin to the upper face. Dermatol Online J. 2005;11(1):9. http://dermatology.cdlib.org/111/pearls/iopidine/scheinfeld.html. Accessed October 15, 2009.
Wilkerson M, Lewis RA, Shields MB. Follicular conjunctivitis associated with apraclonidine. Am J Ophthalmol. 1991;111(1):105–6.
Spooner JJ. Ophthalmic disorders. In: Arcangelo VP, Peterson AM, editors. Pharmacotherapeutics for advanced practice: a practical approach. 2nd ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2006. p. 179.
Hennekes R. Adrenaline sensitivity of senile ptosis. Klin Monatsbl Augenheilkd. 1982;181(6):496–8.
Kass MA, Mandell AI, Goldberg I, Paine JM, Becker B. Dipivefrin and epinephrine treatment of elevated intraocular pressure: a comparative study. Arch Ophthalmol. 1979;97(10):1865–6. http://archopht.ama-assn.org/cgi/reprint/97/10/1865_OnlinePDF.pdf.
Glatt HJ, Fett DR, Putterman AM. Comparison of 2.5% and 10% phenylephrine in the elevation of upper eyelids with ptosis. Ophthalmic Surg. 1990;21(3):173–6.
Nunes TP, Matayoshi S. Phenylephrine 10% eye drop action in the eyelid position in healthy subjects. Arq Bras Oftalmol. 2008;71(5):639–43.
Mapstone R. Provocative tests in closed-angle glaucoma. Br J Ophthalmol. 1976;60(2):115–9.
Brans JW, Aramideh M, Schlingemann RO, Oen VM, Speelman JD, Ongerboer de Visser BW. Cornea protection in ptosis induced by botulinum injection. Ned Tijdschr Geneeskd. 1996;140(19):1031–3.
Fagien S. Temporary management of upper lid ptosis, lid malposition, and eyelid fissure asymmetry with botulinum toxin type A. Plast Reconstr Surg. 2004;114(7):1892–902.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Matjucha, I.C.A. (2011). The Nonsurgical Treatment of Ptosis. In: Cohen, A., Weinberg, D. (eds) Evaluation and Management of Blepharoptosis. Springer, New York, NY. https://doi.org/10.1007/978-0-387-92855-5_16
Download citation
DOI: https://doi.org/10.1007/978-0-387-92855-5_16
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-92854-8
Online ISBN: 978-0-387-92855-5
eBook Packages: MedicineMedicine (R0)