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Dr. Stevens
Dr. Stevens, Ophthalmologist
Category: Eye
Satisfied Customers: 1404
Experience:  Board Certified Ophthalmologist
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85 year old lady right monocular ptosis which varies with level

Customer Question

85 year old lady right monocular ptosis which varies with level of fatique. Slight speech abnormality.
Submitted: 7 years ago.
Category: Eye
Expert:  Dr. Stevens replied 7 years ago.

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 ?

Customer: replied 7 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.
Expert:  Dr. Stevens replied 7 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
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Customer: replied 7 years ago.
I agree I thought about MG but her age is a little too high. Thanks
Expert:  Dr. Stevens replied 7 years ago.
You are welcome, Regards XXXXX