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Unilateral acquired upper eyelid ptosis and decreasing nystagmus
Ivan G Castillo1, Peter J Savino, Helen V Danesh-Meyer
1Neuro-Ophthalmology Service, Wills Eye Hospital, Philadelphia, Pennsylvania 19107, USA.
Purpose:
To describe a patient with congenital nystagmus that decreased in one eye after the development of a cavernous sinus meningioma.
Design:
Interventional case report.
Methods:
A 45-year-old man with congenital nystagmus, albinism, and high myopia presented with right upper eyelid ptosis that was corrected surgically on three occasions during a 3-year period. An episode of syncope was followed by diagnostic evaluation that disclosed a cavernous sinus meningioma. He commented that his right eye nystagmus progressively decreased. He was found to have ophthalmoplegia on the right eye due to nerve compression by the meningioma.
Results:
A magnetic resonance imaging scan disclosed a cavernous sinus meningioma extending into the parachiasmal and clival areas. A biopsy specimen of the lesion demonstrated a meningioma.
Conclusions:
Any patient with acquired ptosis should have a complete ophthalmic examination, including evaluation of extraocular motility.