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DESCRIPTION: A drooping of the upper eyelid when the eyes are open; may occur in one or both eyes; may be constant or intermittent. If the condition is congenital, it is usually a failure of the levator muscle to develop; it may be hereditary (dominant). If the condition is acquired, it is usually the result of a mechanical factor (the lid is simply too heavy for the levator muscle to lift it), associated with disease (commonly muscular dystrophy or myasthenia gravis), or paralytic (related to the malfunctioning of the 3rd cranial nerve). If the lid droops enough to partially cover the pupil, the person attempts to compensate by raising the eyebrow and/or by tilting the head back. If the drooping lid obscures the pupil completely, amblyopia can develop. Disease-caused ptosis progresses gradually; neurally associated ptosis has a range of developmental patterns and behaviors, depending on the type of cranial nerve involvement.

TREATMENT: If the condition does not interfere with visual functioning and does not look cosmetically deforming, it is best left untreated. Surgical correction is possible when vision is threatened.

IMPLICATIONS: Following ptosis surgery, occasionally the eye will not fully close at night. To prevent the eye from drying, ophthalmic ointment or drops may be prescribed.

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