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Isolated left upper eyelid ptosis with pansinusitis and contralateral otitis media in a 9-year-old boy

Nathan D Wilbanks1, Oliver R Filutowski2, Michael D Maldonado3

  • 1Department of Ophthalmology, University of Virginia, 1300 Jefferson Park Ave, Charlottesville, VA, 22908, USA.

American Journal of Ophthalmology Case Reports
|July 28, 2018
PubMed

Insights

A pediatric case of upper eyelid ptosis was linked to extensive sinus and ear infections. Magnetic resonance imaging revealed infection spread to the eye muscle, explaining the unexplained ptosis in a child.

Area of Science:

  • Ophthalmology
  • Pediatrics
  • Otolaryngology

Background:

  • Upper eyelid ptosis presents diverse etiologies in pediatric and adult populations.
  • Common pediatric causes include congenital ptosis, Cranial Nerve (CN) III palsy, Horner's syndrome, and orbital cellulitis.

Observation:

  • A 9-year-old boy presented with left-sided upper eyelid ptosis without signs of localized orbital or preseptal infection.
  • Magnetic resonance imaging (MRI) identified pansinusitis and contralateral otitis media.

Findings:

  • The imaging revealed direct extension of the infection into the superior orbit.
  • This extension impacted the levator palpebrae superioris muscle, the primary muscle responsible for elevating the upper eyelid.

Implications:

  • This case highlights an unusual infectious etiology for pediatric ptosis.
  • It underscores the importance of advanced imaging in diagnosing unexplained cases of ptosis, especially when infection is suspected.
  • Early diagnosis and intervention are crucial to prevent potential vision complications.
Abstract

Keywords:
Orbital cellulitisOtitis mediaPansinusitisPtosis

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