Poor upper lid function,there is
Poor upgaze due to superior
Poor left skin crease
The left eye has poorly defined skin crease. There may be elevation of the chin to gain good binocular vision.
The forehead may be wrinkled due to frontalis overaction. The upgaze is restricted (due to superior rectus
muscle weakness and is the result of close embryologic development between it and the levator).The lid muscle may fail to relax on downgaze (not obvious in this patient; see figures below) and as result the ptotic eye is higher than the normal eye on down gaze.
- look at the lid(s) for previous surgery and also the forehead for any scars from brow suspension slings
- if the patient has glasses, check for anisometropia which is commonly seen in such patient.
1. What are the features of congenital ptosis?