Document Detail


Unilateral congenital ptosis with ipsilateral superior rectus muscle overaction.
MedLine Citation:
PMID:  8862053     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Congenital ptosis may be accompanied by weakness of the ipsilateral superior rectus muscle. We report the finding of a hypertropia of the ipsilateral eye in patients with isolated unilateral congenital ptosis that became manifest only in upgaze. METHODS: Seventy consecutive patients with congenital ptosis were recalled and 58 reexamined. Examination included assessment of visual acuities, palpebral apertures, levator muscle function, and an orthoptic examination. Particular attention was paid to the assessment of upgaze. RESULTS: Thirty-eight patients had an isolated unilateral congenital ptosis. Four patients had bilateral ptosis, six had upgaze deficits, and ten others had a variety of other syndromes associated with ptosis. Seventeen of the 38 patients with isolated unilateral congenital ptosis were found to have an ipsilateral hypertropia on upgaze. The size of the vertical deviation varied from 5 to 30 prism diopters and, in the more severe cases, produced a cosmetic problem that became more noticeable after successful ptosis surgery. In one of these patients, a superior rectus muscle posterior fixation suture was effective in reducing the hypertropia. CONCLUSION: Of a number of possible causes for the ipsilateral hypertropia in upgaze in patients with unilateral congenital ptosis that we observed either a misdirection syndrome within the superior division of the oculomotor nerve or an exaggerated Bell's reflex is the most likely.
Authors:
D H Steel; R A Harrad
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of ophthalmology     Volume:  122     ISSN:  0002-9394     ISO Abbreviation:  Am. J. Ophthalmol.     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1996-11-06     Completed Date:  1996-11-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370500     Medline TA:  Am J Ophthalmol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  550-6     Citation Subset:  AIM; IM    
Affiliation:
Bristol Eye Hospital, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blepharoptosis / complications,  congenital*
Child
Child, Preschool
Cohort Studies
Eye Movements
Female
Humans
Infant
Male
Middle Aged
Oculomotor Muscles / physiopathology
Prevalence
Strabismus / complications*,  diagnosis,  physiopathology
Visual Acuity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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