Ptosis

Differential Overview

❑ Horner syndrome

❑ Diabetic mononeuritis

❑ Eyelid edema

❑ Myasthenia gravis

❑ Posterior communicating artery aneurysm

Diagnostic Approach

Observation of pupillary involvement is the key to differentiating oculomotor (CN III) lesions (mydriasis) from Horner syndrome (miosis).

Clinical Findings

Horner syndrome  Findings include a small pupil, enophthalmos (illusory, caused by retraction of the globe), and anhidrosis with mild vasodilation on the affected side. The ptotic eyelid can still be voluntarily raised.

Diabetic mononeuritis  There may be severe pain and ophthalmoplegia but there is usually pupillary sparing.

Eyelid edema  Usually conjunctival erythema exists, although angioedema may occur without apparent inflammation.

Myasthenia gravis  Ptosis is bilateral and fluctuates, being worse later in the day. Sustained upward gaze produces gradual ptosis of the eyelids. Associated findings include dysconjugate eye movements with sustained horizontal gaze; hoarse, nasal, or slurred voice on prolonged phonation; and inability to sustain motor activity of the limbs.

Posterior communicating artery aneurysm  Ptosis is associated with pupillary dilation and abduction of the eye, with inability to turn the eye medially.

Book Source Details

• Book Title: Field Guide to Bedside Diagnosis
• Author(s): David S. Smith
• Year of Publication: 2007
• Copyright Details: Field Guide to Bedside Diagnosis, Copyright © 2007 Lippincott Williams & Wilkins.

Other Book Chapters Related to Eyelid swelling

Read excerpts from these other book chapters related to Eyelid swelling:

Copyright Details: Field Guide to Bedside Diagnosis, Copyright © 2008 Williams & Wilkins.

More About Causes of Eyelid swelling

• Back to symptom: Eyelid swelling: Introduction (review 100 causes)
• Next Book Extract About Eyelid swelling: Pulmonary edema (Handbook of Diseases)
• All Book Extracts: All Online Book Extracts for Eyelid swelling

More About This Book: Title: Field Guide to Bedside Diagnosis Authors: David S. Smith Publisher: Lippincott Williams & Wilkins Copyright: 2007 ISBN: 0-78178-165-5

 » Next page: Pulmonary edema (Handbook of Diseases)

Rate This Website

What do you think about the features of this website? Take our user survey and have your say:

Website User Survey

Medical Tools & Articles:

Next articles:

• Pulmonary edema (Handbook of Diseases)
• Edema, facial (Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
• Edema, generalized (Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
• Ptosis (Signs & Symptoms: A 2-in-1 Reference for Nurses)
• Edema of the arm (Signs & Symptoms: A 2-in-1 Reference for Nurses)

Tools & Services:

• Bookmark this page
• Take a survey relating to Eyelid swelling
• Symptom Search
• Symptom Checker
• Medical Dictionary
• Give your feedback

Medical Articles:

• Disease & Treatments Search
• Misdiagnosis Center
• Full list of interesting articles

Forums & Message Boards

• Ask or answer a question at the Boards:
• I cannot get a diagnosis. Please help.
• Tell us your medical story.
• Share your misdiagnosis story.
• What is the best treatment for my condition?
• See all the Boards.

Enter your search terms Submit search form
Search The Web Search wrongdiagnosis.com

Common Health Mistakes

Symptom
Checker

Search Specialists by State and City