Consultantlive Staff

A 72-year-old man sought medical evaluationafter he awoke and was unableto open his right eyelid (A). He deniedpain, recent trauma, and diplopia. Thispatient’s history included well-controlledhypertension and hypercholesterolemia,for which he was taking atorvastatin.He did not have diabetes.

Anisocoria and partial eyelid ptosis were detected during the routine eye examination of a 66-year-old woman. These findings had not been present during an examination 2 years earlier. Because the patient had no symptoms, she could not recall when these signs began. Her general health was unremarkable; she had smoked 1 pack of cigarettes per day for 40 years

This 40-year-old man was punched inthe left eye the night before his evaluation.Traumatic ptosis of the left uppereyelid with accompanying edema andperiorbital ecchymosis (A) were found.When the ptotic eyelid was lifted andheld in place with tape, conjunctivalinjection and traumatic mydriasis wereseen (B). The patient had no complaintsof diplopia; the remainder of theeye examination was unremarkable.

A swollen, painful eyelid prompted a 39-year-old man to seek medical attention.The patient had noticed swelling, redness, and irritation in his left lateral eyebrowarea 2 days earlier. Upon awakening on the morning of his appointment,the left upper eyelid also felt full and tender and was drooping. A pointed drainingarea of purulent material had formed in the lateral brow region (not visiblehere). The patient was afebrile and denied any recent periorbital trauma. Hewas otherwise healthy; his only medication was a daily multivitamin.

A 35-year-old woman noticed that herright upper eyelid started to droop asthe day progressed. She denied otherocular problems, including decreasedvisual acuity, pain, or diplopia. The patienthad no generalized fatigue, difficultyin swallowing, or weakness ofher arms or legs.

The parents of a 3-year-old boy wereconcerned about their son's "droopy"right eyelid; the abnormality hadbeen present since birth. All other aspectsof the child's eyes and his generaldevelopment had been normal.