Unilateral congenital ptosis with ipsilateral superior rectus muscle overaction
Unilateral congenital ptosis with ipsilateral superior rectus muscle overaction
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DOI：
10.1016/s0002-9394(14)72116-6
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发表时间：
1996-10-01
影响因子：
4.2
通讯作者：
Harrad, RA
中科院分区：
文献类型：
--
作者：
Steel, DHW;Harrad, RA
目的：先天性上睑下垂可伴有同侧上级直肌无力。我们报告的发现，一个上斜视的同侧眼睛的孤立性单侧先天性上睑下垂，成为明显的只有在upgaze.METHODS：70例先天性上睑下垂连续回顾和58个复查。检查包括视力评估、眼睑孔径、提上睑肌功能和正视检查。特别注意的评估upgaze.Results：38例患者有一个孤立的单侧先天性上睑下垂。4名患者有双侧上睑下垂，6名患者有上视缺陷，另外10名患者有各种与上睑下垂相关的其他综合征。38例单侧先天性上睑下垂患者中有17例在上视时出现同侧上斜视。垂直偏差的大小从5到30棱镜屈光度不等，在更严重的情况下，产生了美容问题，在成功的上睑下垂手术后变得更加明显。在这些患者中，一个上级直肌后固定缝合是有效的，在减少hypertrophi.CONCLUSION：的一些可能的原因，为同侧上斜视在上凝视的患者，我们观察到，无论是一个误导综合征内的上级师的眼神经或夸张的贝尔反射是最有可能的。
PURPOSE: Congenital ptosis may be accompanied by weakness of the ipsilateral superior rectus muscle. We report the finding of a hypertropia of the ipsilateral eye in patients with isolated unilateral congenital ptosis that became manifest only in upgaze.METHODS: Seventy consecutive patients with congenital ptosis were recalled and 58 reexamined. Examination included assessment of visual acuities, palpebral apertures, levator muscle function, and an orthoptic examination. Particular attention was paid to the assessment of upgaze.RESULTS: Thirty-eight patients had an isolated unilateral congenital ptosis. Four patients had bilateral ptosis, six had upgaze deficits, and ten others had a variety of other syndromes associated with ptosis. Seventeen of the 38 patients with isolated unilateral congenital ptosis were found to have an ipsilateral hypertropia on upgaze. The size of the vertical deviation varied from 5 to 30 prism diopters and, in the more severe cases, produced a cosmetic problem that became more noticeable after successful ptosis surgery. In one of these patients, a superior rectus muscle posterior fixation suture was effective in reducing the hypertropia.CONCLUSION: Of a number of possible causes for the ipsilateral hypertropia in upgaze in patients with unilateral congenital ptosis that we observed, either a misdirection syndrome within the superior division of the oculomotor nerve or an exaggerated Bell's reflex is the most likely.