Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Clinical ptosis

3,913 views

Published on

Published in: Health & Medicine, Education

Clinical ptosis

  1. 1. A CASE OF CONGENITAL PTOSIS From department of Ophthalmology and Plastic surgery A case of Congenital ptosisA CASE OF CONGENITAL PTOSIS Dr Samuel Ponraj MS Ophthal [ 1 st year Pg]
  2. 2. • A 20 year old patient who complained of drooping of the left upper eyelid since birth There was no similar complaints in the family O/E : -Severe ptosis > 4 mm of left upper eyelid -Absent lid crease -Bell’s phenomenon [ + ] - Poor levator function of < 5 mm - Normal frontalis action Choice of operation : Frontalis sling operation
  3. 3. ABSENT LID CREASE PTOSIS > 4 mm
  4. 4.  - Test for unilateral /bilateral severity of ptosis  - Measurement of MRD 1 [margin reflex distance] MLD [ margin limbus distance] MCD [ margin crease distance ]  - Upper lid excursion [Levator function]  -Bell’s phenomenon  - Marcus Gunn jaw-winking phenomenon  - Rule out Pseudoptosis PREOPERATIVE ASSESSMENT
  5. 5.  Evaluate for symptoms like Diplopia ,Dryness, Photophobia, Irritation which may worsen after surgery  Pupillary size  Extraocular motility  Examination of orbit  Tensilon test [myasthenia gravis]  Corneal staining [for keratopathy]  Dilated fundus examination  Imaging studies
  6. 6. PRE-OPERATIVE
  7. 7. IMMEDIATE POST OPERATIVE
  8. 8. POST OPERATIVE
  9. 9.  CONGENITAL I. Simple II. Complicated  ACQUIRED I. Neurogenic II. Myogenic III. Aponeurotic IV. Mechanical CLASSIFICATION
  10. 10. Treatments of choice • Fasanella – servat operation • Levator resection - Blaskoviks & Everbusch techniques • Frontalis suspension
  11. 11. THANK YOU

×