Ptosis
| Classification according to ICD-10 | |
|---|---|
| H02.4 | Ptosis of the eyelid |
| ICD-10 online (WHO version 2019) | |
Ptosis ( Greek . Πτῶσις , case, reduction ') or ptosis is called in the ophthalmology the complete or even partial drooping of one or both upper eyelids (Blepharoptosis). The drooping or protruding of the lower eyelid, on the other hand, is called ectropion . Childhood ptosis can lead to amblyopia .
The word ptosis can also generally refer to the sinking of organs under the influence of gravity, e.g. B. the kidneys ( nephroptosis ), the uterus ( uterine subsidence ) , the stomach (gastroptosis) and the breast ( mastoptosis ) as well as the entire abdominal viscera (enteroptosis, Glénard's disease).
causes
Ptosis is just a symptom and can have very different causes:
- Ptosis congenita : Congenital ptosis is often caused by a malformation or lack of development of the muscle responsible for lifting the upper eyelid , the levator palpebrae superioris muscle (hereinafter referred to as levator for short ). This is hereditary and usually one-sided. A hemangioma of the upper eyelid also often leads to ptosis congenita. The symptoms of mandibulopalpebral synkinesis ( Marcus-Gunn syndrome ) and Möbius syndrome are also associated with congenital ptosis.
- Levator damage : Damage to the muscle or its tender end tendon can result from trauma or age-related dysplasia and leads to drooping of the upper eyelid.
- Ptosis paralytica : Damage to the nerve responsible for the levator ( oculomotor nerve ) also leads to ptosis. Since this cranial nerve also provides motor innervation to four of a total of six outer eye muscles , there is usually a paralysis squint .
- Ptosis sympathica : The ptosis caused by damage to the head sympathetic is usually only mild to moderate because the levator is still functional. It is based on the failure of the tarsalis muscle . These are smooth muscles embedded in the lid that tightens the eyelid vertically. Damage to the sympathetic nervous system also leads to further defects in the eye, known as Horner's syndrome .
- Ptosis in muscle diseases : In diseases of the entire muscular system (e.g. myasthenia gravis ), the levator can also be affected.
- Poisoning, for example, from a snake bite with strong neurotoxin (e.g. cobras , mambas ) or food poisoning with the toxin of Clostridium botulinum ( botulism ).
therapy
After any primary causes have been eliminated, the levator is usually corrected surgically. It is possible that the eye can no longer be completely closed during sleep, so that you have to prevent the cornea from drying out with eye drops .
Pseudoptosis
A pseudoptosis is understood to be a disturbance of the eyelid posture caused by relatively large eyelids. This can also occur due to the deterioration in skin tone with age. A pseudoptosis can also result from a lowered eye ( hypotropia ), as well as from blepharospasm .
Web links
Individual evidence
- ^ Pschyrembel clinical dictionary. With clinical syndromes and nouns anatomica. = Clinical Dictionary. Edited by the publisher's dictionary editor under the direction of Christoph Zink. 256th, revised edition. De Gruyter, Berlin et al. 1990, ISBN 3-11-010881-X .
- ^ Hans Adolf Kühn: Diseases of the stomach and duodenum. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition, ibid. 1961, pp. 767-804, here: p. 808.
