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Blepharoptosis,[object Object],Dr. Anupama Karanth,[object Object],www.ophthalclass.blogspot.com,[object Object]
Drooping  of  upper  eyelid,[object Object],Ptosis,[object Object]
Diagnosis of ptosis,[object Object],Drooping of upper eyelid,[object Object],Palpebral fissure is narrowed,[object Object],Upper eyelid covers more than the normal 2 mm of cornea,[object Object],Brow elevation due to frontalisoveraction,[object Object],Chin up head posture in bilateral ptosis,[object Object]
Does this patient have ptosis?,[object Object],Pseudoptosis - Phthisis bulbi ( left eye ) with cataract and iridocyclitis,[object Object]
Pseudoptosis,[object Object],Enophthalmos,[object Object],Microphthalmos,[object Object],Phthisis bulbi,[object Object],Contralateral eye,[object Object],Hypertropia,[object Object],Eyelid retraction,[object Object]
Types  of  ptosis,[object Object]
Congenital  ptosis,[object Object]
Congenital ptosis,[object Object]
Visual function in congenital ptosis,[object Object],Amblyopia is present in 20% of patients with congenital ptosis,[object Object]
Marcus Gunn jaw winking ptosis,[object Object]
Acquired  ptosis,[object Object]
Acquired ptosis,[object Object]
Aponeuroticptosis,[object Object],Most common acquired ptosis,[object Object],[object Object]
Thinning or disinsertion of levatoraponeurosis
Disinsertion from tarsal plate causes retraction of aponeurosis,[object Object]
Aponeuroticptosis,[object Object]
Congenital Myogenic  Vs Acquired AponeuroticPtosis,[object Object]
Myogenicptosis,[object Object]
Myogenicptosis,[object Object],At the level of the myoneural junction,[object Object],[object Object]
Ocular myastheniaAt the level of the muscle,[object Object],[object Object]
Chronic Progressive External Ophthalmoplegia (CPEO)
Oculopharyngeal dystrophy,[object Object]
Involvement of other extraocular muscles
Pigmentary retinopathy
Cardiac conduction abnormalitiesMyotonic dystrophy,[object Object],[object Object]
Christmas tree cataract
Myopathicfacies
Cardiac conduction abnormalities,[object Object]
Antibodies to acetylcholine  receptors
Easy fatiguability
Life threatening symptoms – dysphagia, dyspnoea,[object Object]
IV antiacetylcholinesterase drug, ptosis improves on injection
 Other tests
Ice pack test - improves ptosis

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Lids and Adnexa Class3 - Ptosis