Transient and isolated neurogenic blepharoptosis after medial orbital wall reconstruction.

Abstract

Neurogenic blepharoptosis related to orbital surgery is very rare and only 1

report was published in the literature. This report presents 1 case of transient

and isolated neurogenic blepharoptosis after medial orbital wall reconstruction.

A 12-year-old male patient who suffered from periorbital trauma visited our

hospital with right periorbital pain. During the physical examination, mild

ecchymosis and eyelid edema were reported; however, there were no signs of either

limitation of ocular motion or anisocoria. On the orbital CT images, a 17 mm x 20

mm-sized medial orbital bony defect was observed and the medial rectus muscle and

orbital fat were herniated. The operation was performed 12 days after injury and

the transcaruncular approach was used to reach the medial orbital wall. After the

operation, he had right side blepharoptosis with mild eyelid edema and

ecchymosis. However, ocular movement was normal and there were no signs of

anisocoria. He did not receive any additional medication for blepharoptosis and

was discharged 3 days postoperation. By the ninth day of postoperative recovery,

the patient still suffered from right blepharoptosis with no levator palpebrae

superioris muscle function. We prescribed a low dose of oral corticosteroid and

the patient was monitored on a weekly basis. Finally, he recovered completely

with normal symmetric eyelid position and levator function.