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85 year old lady right monocular ptosis which varies with

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level of fatique. Slight speech...
85 year old lady right monocular ptosis which varies with level of fatique. Slight speech abnormality.
Submitted: 8 years ago.Category: Eye
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Answered in 4 minutes by:
12/6/2009
Eye Doctor: Dr. Stevens, Ophthalmologist replied 8 years ago
Dr. Stevens
Dr. Stevens, Ophthalmologist
Category: Eye
Satisfied Customers: 1,404
Experience: Board Certified Ophthalmologist
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hello there

how long has this been an issue? what is a slight speech abnormality? when did that come on? does her eye ever get so bad as to completely close? do her eyes deviate ?

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Customer reply replied 8 years ago
Time of problem about 5 weeks. Sometimes lid position is normal but it seems to get worse when she is tired. Speech problem is as if lisping. She is also significantly more fatigued than normal. Lid never has closed completely. Recently diagnosed anemic. No diplopia.
Eye Doctor: Dr. Stevens, Ophthalmologist replied 8 years ago
I would get her in with an ophthalmologist who can do a neurologic exam to see if there is anything more concerning than a simple ptosis which is often due to a weak levator muscle (muscle that lifts the eyelid). it is typical that a weak eyelid droops more with fatigue. The speech "lisp" should be assessed as a part of the neuro exam. If the ophthalmologist feels unsure about that exam, he can refer her to a neurologist for more workup. The droopy lid will eventually need surgical correction. There are other causes such as myasthenia gravis and these can be considered during the evaluation but at her age, MG is not very common. I wish her well, Dr. Stevens
Dr. Stevens
Dr. Stevens, Ophthalmologist
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Customer reply replied 8 years ago
I agree I thought about MG but her age is a little too high. Thanks
Eye Doctor: Dr. Stevens, Ophthalmologist replied 8 years ago
You are welcome, Regards *****
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