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Differential Diagnosis for Unilateral Ptosis

Single Most Likely Diagnosis

  • Horner's Syndrome: This condition is characterized by a classic triad of ptosis, miosis, and anhidrosis, resulting from disruption of the sympathetic nerves supplying the eye. It is a common cause of unilateral ptosis and can be due to various etiologies, including stroke, carotid artery dissection, or tumors.

Other Likely Diagnoses

  • Third Cranial Nerve (Oculomotor Nerve) Palsy: This condition can cause unilateral ptosis due to weakness or paralysis of the levator palpebrae superioris muscle. It can be caused by aneurysms, diabetes, or trauma.
  • Myasthenia Gravis: An autoimmune disorder that can cause fluctuating unilateral or bilateral ptosis due to weakness of the extraocular muscles, including the levator palpebrae superioris.
  • Senile Ptosis or Aponeurotic Ptosis: Age-related weakening of the levator aponeurosis, leading to unilateral or bilateral ptosis.

Do Not Miss Diagnoses

  • Cavernous Sinus Thrombosis: A potentially life-threatening condition that can cause unilateral ptosis, along with other symptoms like proptosis, chemosis, and cranial nerve palsies. Prompt diagnosis and treatment are crucial.
  • Giant Cell Arteritis: Although more commonly associated with visual loss, this condition can also cause unilateral ptosis due to ischemia of the extraocular muscles or nerves.
  • Orbital Malignancy: Tumors in the orbit can cause unilateral ptosis by invading or compressing the levator palpebrae superioris muscle or its nerve supply.

Rare Diagnoses

  • Chronic Progressive External Ophthalmoplegia (CPEO): A mitochondrial disorder that causes progressive weakness of the external eye muscles, including the levator palpebrae superioris, leading to unilateral or bilateral ptosis.
  • Oculopharyngeal Muscular Dystrophy: A rare genetic disorder characterized by late-onset ptosis and dysphagia, due to progressive muscle weakness.
  • Congenital Ptosis: Present at birth, this condition can be due to various causes, including poor development of the levator palpebrae superioris muscle or its nerve supply.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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