Left Eye Lid Droop. No Other Symptoms? (photo)

I have worn soft contacts for 33 years. Five weeks ago my left eye lid was partially covering my pupil. NO eye involvement. Blood test for Myasthnia Gravis came back normal. Brain MRI was normal as was the test for Horners. The eye doctor thinks the Ptosis is from contact wear. Eye surgeon does not want to do surgery till i try Mestinon. I started 30mg 2x's per day last Thursday. There has been no change. The eye lid now covers my pupil completly. Could this be just from contact lens wear?

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3 Doctor Answers | Asked by Alberda

Doctor Answers (3)
Community Comments (4)

Mestinon Challenge is Negative with Gradual Ptosis

Given the gradual change you suggested in your more recent post and the negative Mestinon challenge, are you going to undergo ptosis repair?

You willl need bilateral ptosis repair

Your earlier picture would have been helpful . The presentation of ptosis due to the detachment of the levator ligaments to the tarsal plate is gradual and it is unusual to see sudden loss of the muscle function without history of trauma. Your doctor has done full evaluation and surgical repair is the next step.

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Contact lens wear is unlikely to cause this picture.

Your doctors sound very through. I would recommend that you continue to work with them. You might also consider seeing a neuro-ophthalmologist if you have not already done so.

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Comments (4)

Alberda 10 Jan 2013

I am set to have eye lid surgery in early Feb. That is the soonest the surgeon could get me in. There is no improvement with the droopy eye lid. And no other symptoms. Lifting the eye lid to put in and take out contact lens is the only answer they have to my condition. The surgeon said he has never seen it to this extent before. Guess i am one in a million. :) Thanks You all for your replys.

Alberda 20 Dec 2012

Dr. Khoobehi, my neuro ophthalmologist had requested to see pictures of me. It appears that the left lid was drooping over the past year. Although it seems to have been intermittent. I believe that i had possibly been raising my brows to see better. Such an odd thing. Even my neurologist said he has never seen this from contact lens wear.

Alberda 19 Dec 2012

I have seen a neuro opthamologist. She is the one that believes it is from extented contact lens wear. Still no improvement with 60mg of Mestinon 3 times per day.

Alberda 19 Dec 2012

I have seen a neuro opthamologist. She is the one that believes it is from extented contact lens wear. Still no improvement with 60mg of Mestinon 3 times per day.

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