TY  - CHAP
M1  - Book, Section
TI  - Chapter 14. Droopy Eyelids
A1  - Lueder, Gregg T.
PY  - 2011
T2  - Pediatric Practice: Ophthalmology
AB  - Table  Graphic  Jump  Location|Download  (.pdf)|PrintThe  Problem“My  child’s  eyelid  is  droopy.”Common  CausesCongenital  ptosisOther  CausesMyasthenia  gravisHorner  syndromeThird  nerve  palsyEyelid  or  orbital  massPseudoptosisEyelid  retraction  of  opposite  eyeEyebrow  skin  overhanging  normal  eyelidKEY  FINDINGSHistoryCongenital  ptosisPresent  from  birthIsolated,  familial,  or  syndromicOften  worse  with  fatigueChin-up  head  postureMyastheniaVariable  ptosis,  worse  with  fatigueOften  have  strabismus/diplopiaHorner  syndromeCongenital  or  acquiredUnequal  pupilsDecreased  sweating  on  affected  sideUnequal  iris  colors  (if  congenital)Third  cranial  nerve  palsyStrabismus/diplopiaUnequal  pupilsOther  symptoms  depending  on  etiologyEyelid  or  orbital  massEyelid  lesion  or  proptosisPossible  limited  eye  movementOther  symptoms  depending  on  etiologyPseudoptosisMild  appearance  of  ptosis  due  to  excess  skin  overhanging  eyelidSquinting  of  eyelid  due  to  other  ocular  disorder  History  of  light  sensitivityForeign  body  sensation  or  ocular  discomfortEyelid  retraction  on  opposite  sideAlternates  between  eyelid  retraction  of  one  eye  and  ptosis  of  the  otherProptosis  of  opposite  eyeOther  symptoms  depending  on  etiology  of  proptosisExaminationCongenital  ptosisUnilateral  or  bilateral  drooping  of  eyelidsVaries  from  mild  to  almost  complete  occlusionDecreased  ability  to  elevate  eyelidDecreased  eyelid  creaseBrow  lift  and  chin-up  posture  if  marked  ptosisMyasthenia  gravisVariable  ptosisEyelid  twitch  (Cogan’s  sign)Increased  eyelid  opening  after  rest,  ice  testOften  have  strabismusHorner  syndromeUsually  mild-to-moderate  ptosisPupil  smaller  on  affected  sideDecreased  sweating/facial  flushing  on  affected  sideThird  nerve  palsyUsually  moderate  to  marked  ptosisStrabismus  (eye  out  and  down)Unequal  pupils  (pupil  larger  on  affected  side,  except  may  be  smaller  in  congenital  third  nerve  palsy)Eyelid  or  orbital  massVisible  lesion  on  eyelidProptosisLimited  extraocular  movementsPseudoptosisExtra  eyebrow  skinEyelid  height  and  function  normalStrabismusAppearance  of  ptosis  due  to  strabismic  eye  being  lowerVoluntary  closure  due  to  other  ocular  problemsCorneal  foreign  body,  abrasionOther  ocular  inflammatory  disordersEyelid  retraction  on  opposite  sideIf  child  fixes  with  retracted  eye,  opposite  eye  appears  ptoticIf  child  fixes  with  normal  eye,  retraction  worse  in  opposite  eyePossible  proptosis  on  side  with  eyelid  retraction  
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PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesspediatrics.mhmedical.com/content.aspx?aid=56150372
ER  -