4. American Academy of Ophthalmology Staff . The Patient With Eyelid or Facial Abnormalities. In: Basic And Clinical Science Course-
Neuro Opthalmology. Section 5. San Fransisko: American Academy of Ophthalmology. 2016-2017. P- 297-300.
EPIDEMIOLOGY
5. Baiyeroju AM, Oluwatosin OM. Blepharoptosis in Ibadan, Nigeria; West Afr J Med. 2003 Sep;22 (3):208-10.
6. Sridharan GV, Tallis RC, Leatherbarrow B, Forman WM. A community survey of ptosis of the eyelid and pupil size of elderly people.
Age Ageing.1995;24(1):21-4.
ANATOMY EYELID
EYELID ANATOMY
7. American Academy of Ophthalmology Staff . Facial and eyelid anatomy. In: . Basic and clinical course-Orbit, eyelids, and lacrimal
system. Section 7. San Fransisko: American Academy of Ophthalmology. 2016-2017. P. 166-77, 243-54.
EYELID ANATOMY
7. American Academy of Ophthalmology Staff . Facial and eyelid anatomy. In: . Basic and clinical course-Orbit, eyelids, and lacrimal
system. Section 7. San Fransisko: American Academy of Ophthalmology. 2016-2017. P. 166-77, 243-54.
ETIOLOGY
1. Grover AK, Bajega S, Taneja S. Long Case of Ptosis. E Journal of Ophthalmology. 2013. Available at :
http://www.ejournalofophthalmology.com/ejo/ejo13.html
2. Javier GM. Aponeurotic Ptosis. 2017. Available at : http://eyewiki.aao.org/Aponeurotic_ptosis#Disease
8. Sudhakar P. Upper Eyelid Ptosis Revisited. American Journal of Clinical Medicine. 2009.
SYMPTOMS
9. Shome D. Aponeurotic Ptosis (Adult Onset Aqcuired Ptosis). 2016. Available at : http://oculoplastic-eyelid-orbit-
surgery.com/service/adult-senile-aponeurotic-ptosis/
SIGN
• Aponeurotic ptosis: good levator function,
elevation or absence of Upper Eyelid crease
Position and thinning of the eyelids on the tarsal
plate. 10,11
10. Deady JP, Morrell AJ, Sutton GA. Recognising Aponeurotic Ptosis. Journal of Neurology, Neurosurgery and Psychiatry. 1989;52:996-8.
11. Newman, Steven A. 2001. Eyelid Malposition and Involutional Changes, The Foundation of The Academy Of Oftalmology. San
Fransisco.P.190-200.
DIAGNOSIS
• Anamnesis
• Physical examination
• Ptosis evaluation
• Palpebral Fissura Height
• Margin Reflex Distance
• Upper Eyelid Crease
• Levator Function
• Presence of Lagopthalmos
• Margin Limbal Distance
• Bell’s phenomenom
10. Deady JP, Morrell AJ, Sutton GA. Recognising Aponeurotic Ptosis. Journal of Neurology, Neurosurgery and Psychiatry. 1989;52:996-8.
11. Newman, Steven A. 2001. Eyelid Malposition and Involutional Changes, The Foundation of The Academy Of Oftalmology. San
Fransisco.P.190-200.
DIFFERENTIAL DIAGNOSIS
• Blepharophimosis Syndrome 8,12
8. Sudhakar P. Upper Eyelid Ptosis Revisited. American Journal of Clinical Medicine. 2009
12. Allen C, Rubin P. Blepharophimosis-ptosis-epicanthus Inversus Syndrome (BPES): Clnical Manifestation and Treatment. International
Ophthalmology Clinics 2008; 48(2): 15-23.
13. Demirci H. Marcus Gunn Jaw-Winking Synkinesis. Ophthalmology 2010;117(7):1447-52.
DIFFERENTIAL DIAGNOSIS
• Horner Syndrome 14
• Myasthenia Gravis 14
14. Wesley BS, Jesse MV, Richard CA. A Primer on Ptosis. Ophthalmology an Visual Sciences-University of IOWA Healrh Care. 2015.
Available at : http://webeye.ophth.uiowa.edu/eyeforum/tutorials/ptosis/index.htm
DIFFERENTIAL DIAGNOSIS
• Chronic progressive external ophthalmoplegia 1
• Mechanical Ptosis 14
1. Riordan EP, Whitcher JP. 2011. Lids & Lacrimal Apparatus. In: Vaughan and Asbury’s General Ophthalmology. 18th ed. Boston:
McGraw-Hill, P.67-82
14. Wesley BS, Jesse MV, Richard CA. A Primer on Ptosis. Ophthalmology an Visual Sciences-University of IOWA Healrh Care. 2015.
Available at : http://webeye.ophth.uiowa.edu/eyeforum/tutorials/ptosis/index.htm
TREATMENT 2,15
• Levator resection
• Frontalis sling
2. Grover AK, Bajega S, Taneja S. Long Case of Ptosis. E Journal of Ophthalmology. 2013. Available at :
http://www.ejournalofophthalmology.com/ejo/ejo13.html
15. Wei YH, Liao SL. Frontalis Suspension Using Expanded Polytetrafluoroethylene: Result of Differet Surgical Design. 2009. J Formos
Med Assoc. 108:943.
COMPLICATION
16. Brenda C, Edmonson, Allan EW. Ptosis Evaluation and Management. Otolaryngologic Clinics of North America. 2005;38:921-46.
SUMMARY