Unilateral Blepharoptosis Associated with Paradoxical Movement on Abduction.

Choi, Jae Ho; Kim, Hye Young; Lee, Sang Yeul

Case Report

Journal of the Korean Ophthalmological Society 2002;43(7):1345-1348.
Published online July 1, 2002.

Unilateral Blepharoptosis Associated with Paradoxical Movement on Abduction.

Jae Ho Choi, Hye Young Kim, Sang Yeul Lee

¹Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
²National Health Insurance Corporation Ilsan Hospital, South Korea. khyeye@hanmir.com

외전시 역설운동을 동반하는 단안 안검하수

최재호 ( Jae Ho Choi ) , 김혜영 ( Hye Young Kim ) , 이상렬 ( Sang Yeul Lee )

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.

Key Words: Paradoxical movement;Ptosis;Synkinesis