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Updated: Sep 29, 2025

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Psychogenic Ptosis.

Tiffany C Ho1, Steven M Couch, Philip L Custer

  • 1John F. Hardesty, MD, Department of Ophthalmology and Visual Sciences, Washington University in St. Louis, St. Louis, Missouri, U.S.A.

Ophthalmic Plastic and Reconstructive Surgery
|March 24, 2022
PubMed
Summary
This summary is machine-generated.

Psychogenic ptosis, a rare condition often misdiagnosed, typically presents in females after minor trauma. Reassurance can lead to resolution, and psychiatric evaluation is recommended for associated conditions.

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Area of Science:

  • Ophthalmology
  • Psychiatry
  • Neurology

Background:

  • Psychogenic ptosis is an uncommon ophthalmic manifestation linked to conversion disorder.
  • It is frequently misdiagnosed, leading to unnecessary investigations and delayed treatment.

Purpose of the Study:

  • To delineate the clinical parameters, etiology, and psychological aspects of psychogenic ptosis.
  • To improve the diagnostic and therapeutic approach to this rare condition.

Main Methods:

  • A retrospective case series of patients diagnosed with psychogenic ptosis between 1990 and 2020.
  • Review of medical records for demographics, psychiatric history, clinical findings, diagnostics, treatment, and outcomes.
  • A concurrent literature review of published cases from the same period.

Main Results:

  • Six female patients (14-60 years) presented with unilateral psychogenic ptosis, often preceded by physical trauma.
  • Associated signs included brow ptosis, orbicularis oculi spasm, and squint on upgaze.
  • Four patients had pre-existing psychological conditions; reassurance was the primary management.

Conclusions:

  • Psychogenic ptosis is often delayed or misdiagnosed, characterized by specific atypical findings.
  • A history of minor trauma and female sex are common indicators.
  • Reassurance can lead to resolution, and psychiatric evaluation is advised for comorbid conditions.