By Nicholas Robert Galloway MD, FRCS, FRCOphth, Winfried Mawutor Kwaku Amoaku FRCS, FRCOphth, PhD (auth.)
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Mechanical ptosis: inftammation, tumour, and excess skin . Myogenie ptosis: myasthenia gravis . Neurogenie ptosis: sympathetic - Horner's syndrorne, I1Ird cranial nerve palsy, any lesion in the pathway of these, carcinoma of the lung may cause Horner's syndrome. Drugs: guanethidine eye drops cause ptosis . Congenital: ask for childhood photograph, ask for family history. Ingrowing Eyelashes (Trichiasis) The lashes may grow in an aberrant manner even though the eyelids themselves are in good position.
2). This in turn is due to slackening of the fascial attachments of the lower margin of the tarsal plate. At first the eyelid turns in whenever the patient screws up the eyes but eventually the lid becomes permanently turned in so that the lashes are no longer visible externally and rub on the cornea. Such patients complain of watering sore eyes and the matter can be corrected very effectively by eyelid surgery. Entropion may also result from scarring and contracture of the conjunctiva on the inner surface of the eyelid.
Chronic conjunctivitis rnay also be caused by Moraxella lacunata but this organism is rarely isolated from cases nowadays. An important but rare form of purulent conjunctivitis is that due to Neisseria gonorrhoea e; this is still an occasional cause of a severe type of conjunctivitis seen in the new-born babies of infected mothers. Untreated, the corn ea also becomes infected, leading to perforation of the globe and permanent loss of vision. 2) . Ophthalmia neonatorum may also be caused by staphylococci and the chlamydia (see inclu sion conjunctivitis of the new-born).