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Ptosis in Neurologic Disease

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Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery

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Abstract

The true frequency of blepharoptosis and its particular subtypes is not known. The vast majority of upper eyelid ptosis is due to benign etiologies, including involutional and congenital. A recent review of 251 patients across all ages in a tertiary care center reported aponeurotic ptosis as the most frequent subtype (60%), followed by a relatively similar distribution of traumatic, congenital, and mechanical (9–11%). Neurogenic etiologies made up a minority of cases (6%), with 38% due to oculomotor palsy, 29% from myasthenia gravis, and 7% from Horner syndrome. However, this small subset of ptosis cannot be missed - neurologic ptosis may be the sole manifestation of significant systemic and neurologic disease.

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Authors and Affiliations

  1. Attending Surgeon, Oculoplastic and Orbital Surgery Service and Director, Eye Emergency Department, Wills Eye Hospital and Thomas Jefferson University Hospital, Philadelphia, PA, USA

    Ann P. Murchison

  2. Attending Surgeon and Professor of Ophthalmology, Oculoplastic and Orbital Surgery Service, Wills Eye Hospital and Thomas Jefferson University Hospital, Philadelphia, PA, USA

    Jurij R. Bilyk

  3. Clinical Professor of Ophthalmology, Viterbi Famile Department of Ophthalmology, Shiley Eye Institute, University of Califormia San Diego, La Jolla, CA, USA

    Peter J. Savino

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Correspondence to Ann P. Murchison .

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Editors and Affiliations

  1. Oculofacial Plastic Surgeons of Georgia, Suwanee, GA, USA

    J. Javier Servat

  2. Consultants in Ophthalmic and Facial Plastic Surgery, P.C., Southfield, MI, USA

    Evan H. Black

  3. Beaumont Eye Institute, William Beaumont School of Medicine of Oakland University, Rochester, MI, USA

    Frank A. Nesi

  4. Consultants in Ophthalmic and Facial Plastic Surgery, P.C., Southfield, MI, USA

    Geoffrey J. Gladstone

  5. San Antonio Military Medical Center/Wilford Hall Ambulatory Surgery Center, Department of Ophthalmology and Oculoplastic Surgery, San Antonio, TX, USA

    Christopher J. Calvano

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Murchison, A.P., Bilyk, J.R., Savino, P.J. (2021). Ptosis in Neurologic Disease. In: Servat, J.J., Black, E.H., Nesi, F.A., Gladstone, G.J., Calvano, C.J. (eds) Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-41720-8_13

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