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Ptosis 161217144417 PDF
Ptosis 161217144417 PDF
The facial artery provides the angular artery, which passes to the
medial canthal region, anastomosing with the dorsal nasal artery.
The superficial temporal artery supplies eyelid anastomoses via
the transverse facial and zygomatic branches.
The infraorbital artery exits the infraorbital foramen as a terminal
branch of the maxillary artery, anastomosing with vessels of the
lower eyelid.
Anatomy of the eyelid: lymphatics
2- Myogenic:
the problem is in the muscle itself or in the myoneural junction:
E.g: Myasthenia gravis (in 85% of patient with myasthenia gravis,
ptosis can be the initial symptom)
Could be due to myotonic dystrophy
Or trauma to the LPS muscle.
Acquired ptosis cont…
In left hand, you should hold the eyebrow of the patient (to prevent frontalis muscle
to play any role in elevating the lid), then ask the patient to look down, then to look
up ➡ measure the distance between the upper and lower gaze ..
(Measuring the distance between down gaze and up gaze will tell you how many
millimeters LPS can actually lift your lid)
Ideally, distance should be 12mm.
The less the distance between upper and lower gaze = the poorer the LPS muscle
function
Less than 4mm indicates VERY poor LPS function.
4-8 mm = moderate function
More than 8 mm is considered as a reasonably good function.
Additional notes