1,2 The basic etiology of ptosis is weakness of either of two elevators of the upper lid that include levator palpebrae
superioris and muller muscle.
She was diagnosed with TAO, inflammation of the left levator palpebrae
superioris muscle, and pseudoptosis of the right eye.
Instead of tarsorrhaphy or gold weight implants to protect the ocular surface in cases of facial paralysis, corneal damage may be prevented by using BoNT-A injection to the levator palpebrae
superioris muscle to induce eyelid ptosis.
The degree of ptosis, levator palpebrae
superioris function, age of the patient, and the condition of the cornea determine the choice of the surgical procedure.
The ptosis is mostly restricted to the levator palpebrae
and later involves other extraocular muscles.
2,3) More severe forms may involve hypoplasia of the levator palpebrae
superioris muscle or tendon with a minimal or absent eyelid crease.
It also innervates the levator palpebrae
superioris and carries with it the parasympathetic innervations to the pupil.
Because the oculomotor nerve also supplies the levator palpebrae
superioris (LPS) muscle and has a parasympathetic component, it contains roughly five times as many axons (approx.
Lagophthalmos in non-leprosy patients is now commonly managed with upper lid closure augmentation procedures that provide a downward force on the upper lid when the levator palpebrae
While the levator palpebrae
superioris and superior rectus muscles were innervated by the upper branch, the medial rectus, the inferior rectus, and the inferior oblique muscles were innervated by the lower branch (2-4).
Ptosis occurs as a result of a dysfunction of one or both of the upper eyelid elevators--the levator palpebrae
superioris and Muller's muscle.
8-11) Movement of the eye and eyelids are intially affected with the levator palpebrae
, orbicularis oculi, and extraocular muscles becoming involved.