PTOSIS

A B B D E F G And K L M N O U R C T Y P X C H W E I

Ptosis - drooping of the upper eyelid, it is a congenital or acquired. Its cause may be the muscle disease, violation of neuromuscular transmission, the defeat of the oculomotor nerve and its nucleus, violation of sympathetic innervation (Horner's syndrome), trauma, or inflammation of the eyeball. Isolated ptosis in infants is usually caused by a congenital anomaly of the muscle that raises the upper eyelid or tendons, congenital myasthenia or less anomalous innervation of this muscle. Ptosis in children can also be caused by birth trauma, tumors or neurofibromas century (eg, hemangioma). Gradually developing ptosis, is not accompanied by pain, usually caused by myasthenia or muscular lesions. In myasthenia gravis ptosis can be unilateral or bilateral (often asymmetrical), and its severity can vary, but generally increases towards the end of the day (see. Myasthenia gravis). In chronic progressive ophthalmoplegia and ptosis is usually accompanied by a symmetrical two-sided weakness oftalmoparezom and circular muscles of the eye. In dystrophic myotonia bilateral ptosis combined with double-sided weakness of the facial muscles, hair loss temples, weight loss of the temporal muscle myotonia.

Sharply growing painless ptosis is usually neurogenic character, especially when unilateral disease and simultaneous violation of the innervation of the pupil. Easy one-sided ptosis decreases when looking upward, and combined with miosis and slow the expansion of the pupil in the dark - a sign of Horner syndrome (see Anisocoria.), While a more pronounced ptosis, accompanied by a restriction of eye movements upward, inward or downward, as well as with the expansion of the pupil evidence of lesions of the oculomotor nerve. A unilateral lesion of the nucleus of the oculomotor nerve can cause bilateral ptosis, more pronounced on the affected side.

In some cases of ptosis is associated with age-related muscle weakness of the fascia lifting the upper eyelid (ptosis senile) or sagging skin on the eyelid as a result of loss of elasticity.