Ptosis : its diagnosis and value as a localizing symptom / Alison Bradburne.

  • Bradburne, Alison.
Date:
1906
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Licence: In copyright

Credit: Ptosis : its diagnosis and value as a localizing symptom / Alison Bradburne. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    circumstances is seen to attain its highest pitch in abduction of the eye, whilst it diminishes or disappears altogether in attempts at adduction and correspondingly when the jaw is working, as in chewing, the drooped lids jerk up and down involuntarily, and this movement is best seen when the jaw is moved to the side opposite to the ptosis. Ptosis due to congenital defects presents but little difficulty of diagnosis, as the history, appearance and absence of localizing or constitutional causes materially assists us. ACQUIRED PTOSIS. Ptosis is generally considered as an affection belonging solely to the levator palpebral muscle, but, as there are so many other causes which may give rise to a drooping of the eyelid, it is necessary to consider all causes which may give rise to same so as to enable us the more correctly to differentiate between other affections than those of the levator itself. Classification of Acquired Ptosis according to the structures which are at fault or according to the situation of the affection causing it. Thus the structures which may be at fault may be in (A) the lids; (B) the levator muscle; or the lesion may be of (C) central or (D) constitutional origin, or situated in (E) the oculo- motor nerve, or (P) the sympathetic nerve. (A) Acquired ptosis due to an affection of the lids may be due to one of the following: 1. Trachoma. 2. Hypertrophy from overgrowth, i. e., tuberculosis, etc.,' of the structures forming the lid not due to trachoma, or to 3. New growths taking place in the lid, the ptosis in these two last cases being secondary and brought about by the increased weight of the lid itself. 4 Ptosis adiposa, so called by Sichel, who considered it arose from an excessive accumulation of fat, whereas it is in consequence of the bands of fascia connecting the skin with the tendon of the levator not being rigid enough; hence, when the lid is raised, the skin hangs down m the form of a flabby pouch.