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What Causes Severe Painful Ptosis

Posted on Fri, 29 May 2015

Question: Eye problem: My brother is suffering from eyelid dropping or ptosis. He is suffering from last one month and the problem became severe now.. He has lot of pain.. We have consulted Medivision and XXXXXXX hospitals in XXXXXXX but didn't get the proper treatment. I request your suggestion from you..

Answered by Dr. Dadapeer K (41 minutes later)

Brief Answer:
Ptosis requires neurological evaluation.

Detailed Answer:
Hello
Welcome to Health care magic

I am Dr. DADAPEER K, an Ophthalmologist and I will be answering your question.

I reviewed your history.

The symptom of sudden onset of ptosis or eyelid drooping is usually because of neurological lesions like nerve palsies.
The most common cause is the involvement of the third cranial nerve.
This condition requires neurological evaluation by investigations like CT scan to find out the underlying cause and treatment accordingly.

I require further details like
Whether he is having problem of seeing double?
Whether he is having problem of not able to look in all the gaze of directions?

Please do send me reports of any investigations which have been done already like CT scan and modes of treatment, so that I can answer the question more accurately.
Do also send me a photo so that I can confirm the diagnosis.

Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.

Thank you
With regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dadapeer K (40 minutes later)

Thank you very much for your quick reply.. Dr. Dadapeer

1. Yes.. He has swelling/grouping on left eyelid. When he sees left side, images are appearing double.
2. Left side only.. UP/down are clear.

He is the detailed problem description:

I am actual patient and problem started in first of April with grouping of my left eye lid.It looked initially like eye dropping. I consulted Ophthalmologist (Dr.M XXXXXXX XXXXXXX XXXXXXX from MediVision Eye Care Center). He initially suggested Gatalox DM ( I attached prescription) for 3 days and asked me to continue for 12 more days in following visits which cured my problem. He advised me to consult Neuro Physician.

The problem again re occurred on 1st of May again to me, this time with pain.I consulted Neuro Physician (Dr XXXXXXX XXXXXXX from XXXXXXX Hospitol). He advised for tests CBP, ESR, RBS, RNS. Kindly look into the attached reports of CBP, ESR, RB Sugar, RNS (Reptative Nerve Stimulation Study).

He prescribed CLOTAN 200, REJUNEX OD tables for week. I attached prescription.

I appreciate all your suggestions and if you think we should consult any doctor (specialist) in Hyd please let me know the details. I have attached all the reports.

Answered by Dr. Dadapeer K (2 hours later)

Brief Answer:
The treatment is in right direction and he will be fine.

Detailed Answer:
Hello
Thank you for the follow up question.

I reviewed all the reports and photos attached with the question.

All the relevant tests have been done and all are within normal limits.
Hence no need to be worried.
Considering his age, I thick this can be a part of neurological migraine which is characterized by periodic paralysis of the nerves and which will recover eventually.

The treatment prescribed by your doctor in the form of Clotan and Rejunex is in right direction and no need to be worried about it and you need to continue the treatment.

Hence I feel there is no need to be worried other than follow up and he will be improve.

Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.

Thank you
With regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar