Ptosis

Question 1

Neurogenic ptosis

Answer 1

•Caused by innervational defect
•IIIN paresis

Question 2

Myogenic ptosis

Answer 2

•Myopathy of levator muscle
•impairment of impulse transmission

Question 3

Aponeuronic Ptosis

Answer 3

•involutional
•caused by thinning or disinsertion in the lecator aponeurosis

Question 4

Mechanical Ptosis

Answer 4

Gravitational effect of mass or scarring

Question 5

Psudoptosis

Answer 5

False impression of a ptosis

Question 6

False impression of a Ptosis may be:

Answer 6

•dermatochalasis
•lack of lid support from globe
•ipsilateral hypotropia
•contalateral lid retraction
•brow ptosis

Question 7

Margin reflex distance

Answer 7

•Distance between the upper lid margin and corneal reflection
• normal is 4-5mm

Question 8

Palpebral fissure height

Answer 8

•Distance between the upper and lower lid margins

Question 9

Levator function test

Answer 9

•place thumb firmly against Px brow
•Px looks up and excursion is measured
• normal >15mm

Question 10

Upper lid crease measure

Answer 10

•distance between lid margin and lid crease in downgaze

Question 11

Pretarsal show

Answer 11

•distance between lid margin and skin fold while Px looks forward

Question 12

Simple congenital ptosis

Answer 12

•Failure of neuronal migration
•failure of muscular development

Question 13

Marcus Gunn jaw winking syndrome

Answer 13

A branch of CN V is misdirected to the lavator muscle

Question 14

Marcus Gunn jaw winking syndrome treatment

Answer 14

Mild - unilateral levator advancement
Moderate - levator disinsertion
Bilateral levator disinsertion

Question 15

IIICN palsy causes

Answer 15

Vasculopathic - diabetes/hypertension/atherosclerosis

Compressive - aneurysm/neoplasm

Question 16

IIICN palsy signs

Answer 16

•ptosis
•eyeball down and out
•absent accommodation

Question 17

Involutional ptosis

Answer 17

•age related
•thinning or disinsertion of levator aponeurosis
•worsens toward end of the day due to weak mullers muscle