Surgical management of complete blepharoptosis with no levator function from a compressive third nerve palsy

Area of Science:

• Ophthalmology
• Neurosurgery
• Vascular Neurology

Background:

• A 94-year-old monocular woman presented with a third nerve palsy.
• The palsy was caused by a posterior communicating artery aneurysm, leading to complete blepharoptosis and eye movement limitations.

Observation:

• The patient was deemed unsuitable for neurosurgical aneurysm repair.
• Complete ptosis with absent levator function was observed.

Findings:

• A combined Whitnall sling procedure and superior tarsectomy successfully managed the complete ptosis.
• This surgical approach is safe and effective for patients with zero levator function.

Implications:

• This case highlights a viable surgical option for severe blepharoptosis in elderly patients unsuitable for primary aneurysm treatment.
• The described technique offers a safe and effective method for restoring eyelid function in complex cases.