Young Man With Acquired Ptosis

A swollen, painful eyelid prompted a 39-year-old man to seek medical attention.The patient had noticed swelling, redness, and irritation in his left lateral eyebrowarea 2 days earlier. Upon awakening on the morning of his appointment,the left upper eyelid also felt full and tender and was drooping. A pointed drainingarea of purulent material had formed in the lateral brow region (not visiblehere). The patient was afebrile and denied any recent periorbital trauma. Hewas otherwise healthy; his only medication was a daily multivitamin.

Mechanical ptosis can occur when tumors or edema force the lid to droop.Often the mobility of the eyelid can be impaired. To correct the condition, treatthe underlying cause.

This patient was told to use hot compresses to hasten the pointing andresolution of the abscess. Cephalexin was prescribed, because Staphylococcusinfections cause the vast majority of abscesses and microabscesses of the lidsand periocular area. Monitor such patients for staphylococcal septicemia, orbitalcellulitis, and cavernous sinus sepsis.

Reserve incision and drainage for recalcitrant cases. Because the orbitalseptum acts as an effective barrier to the spread of infection into the orbit, takecare not to open it in the course of incision and drainage.¹

References:

REFERENCE:

1.

Griffith DG, Salasche SJ, Clemons DE, eds.

Cutaneous Abnormalities of the Eyelid and Face: An Atlas WithHistopathology.

New York: McGraw-Hill; 1987:312-316.