J Korean Ophthalmol Soc.  2002 Jul;43(7):1345-1348.

Unilateral Blepharoptosis Associated with Paradoxical Movement on Abduction

• Choi JH
• Kim HY
• Lee SY

Abstract

PURPOSE: This case is the first report of unilateral ptosis associated with paradoxical movement on abduction in Korean literature and we report this case with a successful result of operations.
METHODS
We examined an 18-year-old male patient who had showed drooping of right eyelid since birth. The ptosis was exaggerated on abduction. He did not have any remarkable history of illness. Corrected visual acuity was 20/20 in both eyes. Ocular motility examination revealed full range of ductions and versions in all fields of gaze. On exophthalmometric examination, no difference was found in any direction of gaze between two eyes. Under the diagnosis of unilateral ptosis associated with paradoxical movement on abduction, levator resection of right upper lid and blepharoplasty of left upper lid were performed.
RESULTS
During operation, we noticed unusual finding that thickened tendon sheath was covering the lateral one third of levator aponeurosis. Paradoxical eyelid movement disappeared completely after secondary operation by removal of the previously noticed tendon sheath as much as possible.

Keyword

Paradoxical movement; Ptosis; Synkinesis

MeSH Terms

Adolescent
Blepharoplasty
Blepharoptosis*
Diagnosis
Eyelids
Humans
Male
Parturition
Synkinesis
Tendons
Visual Acuity