Advertisement

Acquired Ptosis: Classification and Evaluation

  • John D. Siddens
  • Sonya D. Mitchell
  • Geoffrey J. Gladstone
Chapter

Abstract

Blepharoptosis is a unilateral or bilateral droop of the upper eyelid with the patient’s head in the fully upright position and eyes in primary gaze. Patients often seek medical attention because of visual obstruction or cosmetic deformity caused by ptotic lids. Ptosis is often recognized by friends or family, but some cases may be seen only by a physician. Ptosis may be an isolated condition, or it may occur from a number of different causes.

Keywords

Levator Muscle Eyelid Margin Chronic Progressive External Ophthalmoplegia Tarsal Plate Ophthalmoplegic Migraine 
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.

References

  1. 1.
    Anderson RL, Beard C. The levator aponeurosis. Attachments and their clinical significance. Arch Ophthalmol. 1977;95:1437.PubMedCrossRefGoogle Scholar
  2. 2.
    Berk RN, Wadsworth JAC. Histology of levator muscles in congenital and acquired ptosis. Arch Ophthalmol. 1955;53:413.CrossRefGoogle Scholar
  3. 3.
    Jones LT. The anatomy of the upper eyelid and its relation to ptosis surgery. Am J Ophthalmol. 1964;57:943.PubMedGoogle Scholar
  4. 4.
    Kuwabara T, Cogan DG, Johnson CC. Structure of the muscles of the upper eyelid. Arch Ophthalmol. 1975;93:1189.PubMedCrossRefGoogle Scholar
  5. 5.
    Doxanas MT, Anderson RL. Clinical orbital anatomy. Baltimore: Williams & Wilkins; 1984.Google Scholar
  6. 6.
    Doxanas MT. Simplified aponeurotic ptosis surgery. Ophthalmic Surg. 1992;23(8):512.PubMedGoogle Scholar
  7. 7.
    Beard C. Ptosis. 2nd ed. St. Louis: CV Mosby; 1976.Google Scholar
  8. 8.
    Beard C. Ptosis surgery: past, present, and future. Ophthal Plast Reconstr Surg. 1985;1:69.PubMedCrossRefGoogle Scholar
  9. 9.
    Freuh BR. The mechanistic classification of ptosis. Ophthalmology. 1980;87:1019.CrossRefGoogle Scholar
  10. 10.
    Dortzbach RK, Sutula FC. Involutional blepharoptosis: a histopathological study. Arch Ophthalmol. 1980;98:2045.PubMedCrossRefGoogle Scholar
  11. 11.
    Bailey CS, Buckley RJ. Ocular prostheses and contact lenses. I- Cosmetic devices. BMJ. 1991;302:1010.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Kersten RC, De Conciliis C, Kulwin DR. Acquired ptosis in the young and middle-aged adult population. Ophthalmology. 1995;102:924.PubMedCrossRefGoogle Scholar
  13. 13.
    Van den Bosch WA, Lemij HG. Blepharoptosis induced by prolonged hard contact lens wear. Ophthalmology. 1991;99:1759.CrossRefGoogle Scholar
  14. 14.
    Glaser JS, Miller GR, Gass DM. The edrophonium test in myasthenia gravis. Arch Ophthalmol. 1966;76:368.PubMedCrossRefGoogle Scholar
  15. 15.
    Miller NR, Cornblath DR. Myasthenia gravis. In: Fraunfelder FT, Roy FH, editors. Current ocular therapy, vol. 4. Philadelphia: WB Saunders; 1995.Google Scholar
  16. 16.
    Weinberg DA, Lester RL, Vollmer TL. Ocular myasthenia: a protean disorder. Surv Ophthalmol. 1994;39:169.PubMedCrossRefGoogle Scholar
  17. 17.
    Johnson CC, Kuwabara T. Oculopharyngeal muscular dystrophy. Am J Ophthalmol. 1964;77:872.Google Scholar
  18. 18.
    Burian HM, Burns CA. Ocular changes in muscular dystrophy. Am J Ophthalmol. 1967;63:22.PubMedGoogle Scholar
  19. 19.
    Guy JR, Day AL. Intracranial aneurysm with superior division paresis of the oculomotor nerve. Ophthalmology. 1989;96:1071.PubMedCrossRefGoogle Scholar
  20. 20.
    Savino PJ, Moster ML. Ptosis in neurologic diseases. In: Smith BC et al., editors. Ophthalmic plastic and reconstructive surgery. St. Louis: CV Mosby; 1987.Google Scholar
  21. 21.
    Sedwick LA. Ptosis. In: Margo CV, Hamed LM, Mames RN, editors. Diagnostic problems in clinical ophthalmology. Philadelphia: WB Saunders; 1994.Google Scholar
  22. 22.
    Vigayan N. Ophthalmoplegic migraine: ischemic or compressive neuropathy? Headache. 1980;20:300.CrossRefGoogle Scholar
  23. 23.
    Arnold AC. Ophthalmic manifestations of multiple sclerosis. Semin Ophthalmol. 1988;3:229.CrossRefGoogle Scholar
  24. 24.
    Beck RW, et al. A randomized controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med. 1992;326:581.PubMedCrossRefGoogle Scholar
  25. 25.
    Optic Neuritis Study Group. The clinical profile of optic neuritis. Experience of the optic neuritis treatment trial. Arch Ophthalmol. 1991;104:1673.Google Scholar
  26. 26.
    Sullivan JH. Ptosis. In: Fraunfelder FT, Roy FH, editors. Current ocular therapy, vol. 4. Philadelphia: WB Saunders; 1995.Google Scholar
  27. 27.
    Hamann K-U. Acute idiopathic polyneuritis. In: Fraunfelder FT, Roy FH, editors. Current ocular therapy, vol. 4. Philadelphia: WB Saunders; 1995.Google Scholar
  28. 28.
    Deadly JD, Price NJ, Sutton GA. Ptosis following cataract and trabeculectomy surgery. Br J Ophthalmol. 1989;73:283.CrossRefGoogle Scholar
  29. 29.
    Jordan DR. Blepharochalasis syndrome. Can J Ophthalmol. 1992;27:10.PubMedGoogle Scholar
  30. 30.
    Sarver BL, Putterman AM. Margin limbal distance to determining amount of levator resection. Arch Ophthalmol. 1985;103:354.PubMedCrossRefGoogle Scholar
  31. 31.
    Small RG, Sabates NR, Burrows D. The measurement and definition of ptosis. Ophthal Plast Reconstr Surg. 1989;56:171.CrossRefGoogle Scholar
  32. 32.
    Glatt HJ, Fett DR, Putterman AM. Comparison of 2.5% and 10% phenylephrine testing in the elevation of upper eyelids with ptosis. Ophthalmic Surg. 1990;21:173–6.PubMedGoogle Scholar
  33. 33.
    Beard C. Examination and evaluation of the ptosis patient. In: Smith BC et al., editors. Ophthalmic plastic and reconstructive surgery. St Louis: CV Mosby; 1987.Google Scholar
  34. 34.
    Yip CC, Foo FY. The role of Müller’s muscle-conjunctival resection in the treatment of ptosis. Ann Acad Med Singapore. 2007;36(Supple):22–6.Google Scholar
  35. 35.
    Dryden RM, Kahanic DA. Worsening of blepharoptosis in downgaze. Ophthal Plast Reconstr Surg. 1992;2:126.CrossRefGoogle Scholar
  36. 36.
    Wojno TH. Downgaze ptosis. Ophthal Plast Reconstr Surg. 1993;2:83–9.CrossRefGoogle Scholar
  37. 37.
    Cahill KV, Burns JA, Weber PA. The effect of blepharoptosis on the field of vision. Ophthal Plast Reconstr Surg. 1987;3:121.PubMedCrossRefGoogle Scholar
  38. 38.
    Meyer DR, et al. Quantitating the superior visual field loss associated with ptosis. Arch Ophthalmol. 1989;107:840.PubMedCrossRefGoogle Scholar
  39. 39.
    Patipa M. Visual field loss in primary gaze and reading gaze due to acquired blepharoptosis and visual field improvement following ptosis surgery. Arch Ophthalmol. 1992;110:63.PubMedCrossRefGoogle Scholar
  40. 40.
    Waller RP, McCord CD, Tannenbaum M. Evaluation and management of the ptosis patient. In: McCord CD, Tannenbaum M, editors. Oculoplastic surgery. New York: Raven; 1987.Google Scholar
  41. 41.
    Medicare part B medical policy procedures: upper eyelid and brow surgical procedures; Feb 1995.Google Scholar
  42. 42.
    Schulman BH. Psychiatric issues in cosmetic blepharoplasty. In: Putterman AM, editor. Cosmetic oculoplastic surgery. 2nd ed. Philadelphia: WB Saunders; 1993.Google Scholar
  43. 43.
    Thompson JA, Knox HJ, Edgerten MT. Cosmetic surgery, the psychiatric perspective. Psychosomatics. 1978;19:7.CrossRefGoogle Scholar
  44. 44.
    Putterman AM. Patient satisfaction in oculoplastic surgery. Ophthalmic Surg. 1990;21:15.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • John D. Siddens
    • 1
  • Sonya D. Mitchell
    • 2
  • Geoffrey J. Gladstone
    • 3
    • 4
    • 5
  1. 1.UMG Plastic SurgeryGreenville Hospital SystemGreenvilleUSA
  2. 2.Bassin Center for Facial Plastic SurgeryMelbourneUSA
  3. 3.Oakland University William Beaumont School of MedicineRoyal OakUSA
  4. 4.Department of Ophthalmology, Kresge Eye InstituteWayne State University School of MedicineDetroitUSA
  5. 5.Consultants in Ophthalmic & Facial Plastic Surgery, P.CSouthfieldUSA

Personalised recommendations