A Case of Complete Recovery of Isolated Neurogenic Ptosis after Trauma

ABSTRACT

PURPOSE: To report a rare case of isolated neurogenic blepharoptosis secondary to eyelid trauma. CASE SUMMARY: A previously healthy 41-year-old male was evaluated for decreased visual acuity and blepharoptosis in the left eye after ocular trauma. On ophthalmologic examination, visual acuity in the left eye was hand motion, intraocular pressure was 29 mm Hg, hematoma and eyelid edema were minimal. The patient had complete unilateral ptosis with superficial upper eyelid laceration. Additional findings in the left eye included fracture of the medial orbital wall, hyphema, iris sphincter muscle tear, iridodialysis and conjunctival laceration. The other examinations were unremarkable with full ocular motility. Because of iris sphincter muscle tear and iridodialysis, the pupillary reaction could not be evaluated. His left upper eyelid drooped completely and levator function test (LFT) was 0 mm. He was diagnosed with an isolated neurogenic blepharoptosis and received oral prednisolone at a dose of 1 mg/kg per day for 7 days with gradual tapering. One month later, the patient had normal symmetric lid height and completely restored levator function.