Ptosis

Definition

Ptosis is the drooping or falling of the upper eyelid. It may be unilateral or bilateral, congenital or acquired.

Causes

• Myasthenia gravis (muscle fatigue with use; worse at end of day)
• Third cranial nerve palsy
• Horner's syndrome (ptosis + miosis + anhidrosis)
• Aging (senile ptosis)
• Botulism
• Congenital
• Trauma

Myasthenia Gravis

Classic presentation: Ptosis and diplopia that worsen with use. Edrophonium (Tensilon) test. Temporary symptom relief confirms diagnosis, such as treated with acetylcholinesterase inhibitors (pyridostigmine), immunosuppressants, thymectomy. Myasthenic crisis: severe weakness + respiratory failure.

Nursing Interventions

Assess muscle strength, bulbar function (swallowing, speech). Monitor respiratory status. Administer medications on schedule. Protect the affected eye (artificial tears, patch at night).

NCLEX Relevance

Ptosis + diplopia worsening with activity = myasthenia gravis.