Miasthenia gravis disease, distrophia miatonica, bilateral Horner's syndrome

Ptosis is the condition in which eye lid covers half of the eye or just cannot be opened completely. It can be unilateral or bilateral. The sign can be seen with muscle damage, nerve damage, and inflammation or hormone effects. Bilateral ptosis is seen in neurotoxic effects of botulism, older age, congenital abnormality of levator development, auto immune diseases, direct damage to third nerve by tumor, diabetes, or pan coast tumor, myasthenia gravis, occular muscle dystrophy, snake poisons ( black mamba), chronic inflammation ( contact lens), post-surgical complications, hypothyroidism or drug induced ( opioids, morphine, heroin, oxycodone, pregablins. Diagnostic tools include: physical exam, medical history, other specific symptoms, slit lamp examination, tensilon test, visual field tests, thyroid profile or scans. Management depends in the type of ptosis: surgical correction for congenital and aponeurotic issues, crutch glasses and hormone therapy .