ptosis
Introduction
Introduction to ptosis The ptosis refers to the insufficiency or loss of the superior iliac muscle and Müller smooth muscle, so that the upper sac appears partially or completely sag, the lighter covers part of the pupil, and the severe pupil is covered, and congenital can also cause amblyopia. In order to overcome the visual impairment, the two sides of the drooping person, due to the need to look up the object, form a special posture of the head wrinkle. In order to estimate the function of the levator muscle, the position of the upper iliac crest when the eyeball is extremely upward and downward is measured under the premise of offsetting the contraction strength of the frontal muscle. If the difference between the front and the back is less than 4mm, it means that the diaphragmatic function is severely incomplete. basic knowledge Sickness ratio: 0.001%-0.3% Susceptible people: no special people Mode of infection: non-infectious Complications: exposed keratitis
Cause
Cause of ptosis
Myogenic ptosis (30%):
More common in myasthenia gravis, often accompanied by the phenomenon that the whole body is easily fatigued, but there are cases that occur only in the extraocular muscles and do not develop to other muscles for a long time. This kind of ptosis is characterized by a good rest after a break. Immediately increased in the eyes, light in the morning and heavy in the afternoon, subcutaneous or intramuscular injection of neostigmine 0.3 ~ 1.5mg, after 15 to 30 minutes, the symptoms temporarily relieved.
Sympathetic ptosis (25%):
For the dysfunction of the muscle or due to damage to the cervical sympathetic nerve, if the latter, there will be ipsilateral pupil dilation, eyeball retraction, facial flushing and no sweat, etc., called Horner syndrome, oculomotor nerve paralysis Most of them are monocular, often combined with oculomotor nerves to innervate other extraocular muscles or intraocular muscle paralysis.
Other (30%):
(1) traumatic injury to the oculomotor nerve or lifting the diaphragm, Müller muscle, can cause traumatic ptosis.
(2) The diseases of the eyelid itself, such as severe trachoma, ankle tumor, etc., cause the weight of the eyelid to increase and cause mechanical ptosis.
(3) No eyeballs, small eyeballs, eyeball atrophy and various causes of decreased fat or sputum content can cause false ptosis.
Prevention
Capillary prolapse prevention
The ptosis is mostly congenital and hereditary. Sometimes it can be accompanied by internal suede, small cleft palate, narrow eyelids, strabismus, etc. Some ptosis is formed by the day after tomorrow, mostly unilateral, traumatic , caused by muscle or oculomotor nerve damage after the disease, so pay attention to prevent eye trauma.
Complication
Upper ptosis complication Complications, exposed keratitis, varus
Complications usually occur after surgery, such as double vision, exposed keratitis, conjunctival prolapse, and varus.
Symptom
Symptoms of ptosis and drooping common symptoms eyelid drooping eyelids loose upper eyelid thickening and relaxing binocular Bell now... edge is horizontal "S" shaped drooping amblyopia eyelid drooping
The main symptom is that the upper jaw can not be lifted. The patient often tightens the frontal muscles, wrinkles, shrugs to help lift the sputum, and the heavy one needs to look up at the object. If it is a child, and the sag is more than the pupil, it can often cause amblyopia.
Examine
Examination of ptosis
In normal people, the upper margin of the sacral margin covers 2mm of the upper edge of the cornea, and the average width of the cleavage is about 7.5mm. In order to estimate the function of the levator palpebral muscle, the eyeball is measured upwards under the premise of offsetting the contraction strength of the frontal muscle. The position of the upper temporal margin of the lower gaze, the normal person should be more than 8mm, if the difference between the front and the back is less than 4mm, it means that the diaphragmatic function is severely incomplete.
Diagnosis
Diagnosis of ptosis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
To be differentiated from myasthenia gravis or sympathetic droop.
