My eyelids seem to droop when I am relaxed. Could it be ptosis?

Question

Hi doctor,

From the past 12 months, my eyelids seem to droop when in a normal or relaxed state. It takes an effort to perform any kind of activity. I am doing eye exercises, but their effects are temporary. My eyelids close even more often after I use mobile or laptop. Could it be ptosis? If yes, how can it be treated naturally? What about surgery? I have attached few photos of my eyelids.

Answer 1

Hello,

Welcome to icliniq.com.

I have reviewed your photos very carefully (attachment removed to protect patient identity). There is no significant ptosis in your eyes. Recently acquired ptosis, which worsens with efforts, is suggestive of myasthenia gravis. I would recommend you to consult a local ophthalmologist and get proper examinations done to rule out myasthenia. The most sensitive clinical test is theice test. Other tests that can be performed in the clinic include fatigue test. I am sorry, but there is no natural method to treat this. I would like you to consult a local ophthalmologist and get proper eye examination done. I hope this will help you. Regards.

Answer 2

Hello,

Welcome to icliniq.com.

Retinal holes are not related to your presenting symptoms. As you mentioned that the ptosis is transient and increases as you try to keep eyes open, this is strongly suggestive of myasthenia gravis. In this condition, ptosis shows diurnal variability, which means that the amount of ptosis varies. Ptosis is less in morning and increases as the day progresses. Simple clinical tests to detect this are ice test, fatigue test, and Cogan's twitch sign. Other tests include nerve fiber stimulation test, Neostigmine test, etc. I would recommend you to consult your ophthalmologist again and request him to rule out myasthenia. Meanwhile, you can use lubricating eye drops frequently like refresh tears. I hope this will help you. Regards.