Evaluation of ptosis

Last reviewed: 7 Apr 2025
Last updated: 21 Nov 2023

Summary

Differentials

Common

  • Involutional changes
  • Prolapsed orbital fat
  • Dermatochalasis
  • Congenital myogenic ptosis
  • Thyroid eye disease
  • Previous eye-related surgery or implant
  • Chalazion
  • Stye (hordeolum)
  • Uveitis
  • Orbital cellulitis
  • Orbital inflammatory syndrome
  • Eyelid tumors
  • Orbital tumors
  • Chronic progressive external ophthalmoplegia (CPEO)
  • Stroke
  • Eyelid foreign body
  • Eyelid laceration
Full details

Uncommon

  • Blepharophimosis
  • Myasthenia gravis
  • Multiple sclerosis
  • Blepharochalasis
  • Giant cell arteritis
  • Preseptal cellulitis
  • Globe malposition
  • Benign essential blepharospasm (BEB)
  • Third nerve palsy
  • Horner syndrome
  • Transection of levator muscle or aponeurosis
  • Orbital and facial fracture
Full details

Contributors

Authors

Kiran Sajja, MD

Milan Eye Center

Oculoplastic Surgery

Johns Creek

GA

Disclosures

KS declares that he has no competing interests.

Acknowledgements

Dr Kiran Sajja would like to gratefully acknowledge Dr Allen M. Putterman, a previous contributor for this topic.

Disclosures

AMP declares that he has no competing interests.

Peer reviewers

Ilse Mombaerts, MD, PhD

Department of Ophthalmology

University Hospitals

Leuven Kapucijnenvoer

Leuven

Belgium

Disclosures

IM declares that she has no competing interests.

Alon Kahana, MD, PhD

Assistant Professor

Kellogg Eye Center

Assistant Professor

Ophthalmology and Visual Sciences

Comprehensive Cancer Center

University of Michigan

Ann Arbor

MI

Disclosures

AK declares that he has no competing interests.

References

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Key articles

Finsterer J. Ptosis: causes, presentation, and management. Aesthetic Plast Surg. 2003;27:193-204. Abstract

Yanovitch T, Buckley E. Diagnosis and management of third nerve palsy. Curr Opin Ophthalmol. 2007 Sep;18(5):373-8. Abstract

American College of Radiology. ACR Appropriateness Criteria. Orbits, vision and visual loss. 2017 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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