Ten Tips for the Beginner to Examine a Patient of Ptosis
1. History A careful history helps in identifying the etiology of ptosis (Fig 1). The age at onset of ptosis and its duration will usually distinguish congenital from acquired cases. Relevant history should be elicited in all patients regarding the variability of ptosis during the day, associations with any jaw movements, abnormal ocular movements and head posture, diplopia, or tiredness. Old photographs often reveal important information. A family history of similar conditions should be determined to rule out Congenital or hereditary ptosis, blepharophimosis, ocular myopathies, etc. Any history of previous surgery, trauma, or use of steroids should be recorded. According to its etiology, it can be classified as myogenic, aponeurotic, neurogenic, neuromuscular, mechanical, or traumatic. Figure 1: Young female with Left eye severe ptosis 2. Ruling out pseudoptosis There are conditions that can mimic ptosis include enophthalmos, anophthalmos, contralateral proptosis, contralateral lid re
Dr. A. K. Grover · Dr. Shaloo Bageja · +1 other