Differential Diagnosis for a Man with Ptosis ODS (Ocular Dominance Syndrome) More Prominent Since Losing Weight

• Single Most Likely Diagnosis
  • Horner's Syndrome: This condition is characterized by ptosis, miosis, and anhidrosis. Weight loss could be a symptom of an underlying condition causing Horner's Syndrome, such as a pancreatic or lung tumor affecting the sympathetic nervous system. The ptosis in Horner's Syndrome is typically mild and may become more noticeable with weight loss due to the reduction in facial fat.
• Other Likely Diagnoses
  • Myasthenia Gravis: An autoimmune disease that can cause fluctuating ptosis, which may worsen with fatigue or after periods of activity. Weight loss could be a symptom of the disease itself or due to difficulty eating because of muscle weakness.
  • Third Cranial Nerve Palsy: This can cause ptosis, and while it's not directly related to weight loss, conditions that lead to weight loss (like diabetes or a tumor) can also cause a third cranial nerve palsy.
• Do Not Miss Diagnoses
  • Pituitary Tumor: Although less common, a pituitary tumor can cause ptosis by affecting the third cranial nerve. Weight loss could be a symptom of hormonal imbalances caused by the tumor.
  • Carcinoid Syndrome: This rare condition, often associated with neuroendocrine tumors, can cause weight loss and flushing. While not directly linked to ptosis, the systemic nature of the disease and potential for metastasis to the brain could indirectly lead to neurological symptoms.
• Rare Diagnoses
  • Mitochondrial Myopathies: These are a group of disorders that affect the mitochondria, leading to muscle weakness, which can include the muscles around the eye, causing ptosis. Weight loss can occur due to muscle wasting and metabolic disturbances.
  • Chronic Progressive External Ophthalmoplegia (CPEO): A mitochondrial disorder that leads to progressive weakness of the external eye muscles, causing ptosis and limitations in eye movement. Weight loss might not be a direct symptom but could occur due to associated systemic conditions or difficulty eating.