Acquired Ptosis-Traumatic

This 40-year-old man was punched inthe left eye the night before his evaluation.Traumatic ptosis of the left uppereyelid with accompanying edema andperiorbital ecchymosis (A) were found.When the ptotic eyelid was lifted andheld in place with tape, conjunctivalinjection and traumatic mydriasis wereseen (B). The patient had no complaintsof diplopia; the remainder of theeye examination was unremarkable.

Blunt trauma to the eyelids andperiorbital area can result in simpleecchymosis and edema. Treatmentconsists of cold compresses and reassurance.Injury to the upper eyelidcan result in traumatic ptosis that usuallyresolves as the edema subsides.Occasionally, traumatic ptosis can lastfor months before lid function returns;therefore, delay surgical repair aslong as possible. Traumatic mydriasisalso usually resolves, but it can persistindefinitely.

After 2 weeks this patient's ptosiscleared; however, a slight anisocoriapersisted (C).