Etiology:
There are many reasons for ptosis, involving neurology, ophthalmology and endocrinology. Eyelid ptosis is clinically divided into congenital and acquired. Congenital, the eyes do not open after birth, which is caused by the hypoplasia of oculomotor nerve branch passing through levator palpebrae or oculomotor nerve nucleus. Acquired ptosis is caused by oculomotor nerve paralysis, trachoma, tumor, inflammation and trauma, eyelid hypertrophy and levator palpebralis muscle injury. Eyelid droop can involve both eyes or one eye, and the eyelid covers the pupil, which is not easy to see clearly. Children's ptosis is mainly congenital simple ptosis, jaw blink syndrome, myasthenia gravis and trauma. The main causes of adult ptosis include myasthenia gravis, chronic progressive extraocular muscle paralysis, hyperthyroidism eye disease, intracranial aneurysm compression ptosis and so on. The main causes of ptosis in the elderly include senile ocular aponeurosis, myasthenia gravis, ptosis after cerebral infarction, diabetic oculomotor nerve paralysis and so on.
Principles of treatment:
1. Diabetes
After diagnosis, drugs for lowering blood sugar and nourishing nerves and traditional Chinese medicine for promoting blood circulation and removing blood stasis were given in time.
2. Caused by intracranial aneurysm
It is unilateral sudden ptosis with dilated pupils. If accompanied by severe headache, vomiting, convulsions, coma, etc. It is likely that the ruptured aneurysm leads to subarachnoid hemorrhage, so you should go to the hospital for emergency treatment in neurology immediately.
3. Caused by brain stem lesions
The patient has drooping eyelids and dilated pupils on one side, and numbness and weakness in the upper and lower limbs on the other side. Brain stem tumors often occur in children and cerebrovascular diseases often occur in the elderly, which can be diagnosed by magnetic resonance imaging.
4. Caused by myasthenia gravis
Eyelid droop develops slowly, first in one eye and then in the other. Clinical symptoms are light in the morning and heavy at night, and fluctuate obviously within one day. Neostigmine test, repeated electrical stimulation and acetylcholine receptor antibody determination can confirm the diagnosis. Immunosuppression therapy should be actively used after diagnosis, and patients with thymoma should be evaluated for surgery.
5. Congenital ptosis
It should be corrected by surgery. Fetuses will find drooping eyelids at birth, mostly unilateral or bilateral. This kind of eyelid is only suitable for surgical correction with age.