Neurogenic blepharoptosis is an important entity to recognize since there are specific considerations in its evaluation and treatment. Most cases are caused by lesions of the oculomotor nerve or a disruption of the oculosympathetic pathway. Neurogenic ptosis can be distinguished from involutional blepharoptosis by the associated findings of pupillary and/or ocular motility abnormalities. The etiology and localization of the lesion is determined by a careful review of the history, associated signs and symptoms, and appropriate neuroimaging studies. The initial treatment approach is aimed at correcting the underlying pathologic process. For patients who require surgical repair of the ptosis, frontalis sling is the only viable option for patients with oculomotor nerve palsy, while both levator resection and Müllerectomy are effective procedures for patients with Horner syndrome.
KeywordsNerve Palsy Cavernous Sinus Oculomotor Nerve Levator Muscle Pharmacologic Testing