On the cause of insidiously progressive diabetic blepharoptosis

Abstract

In many diabetics a slowly progressive blepharoptosis develops with intact upper eyelid crease, without signs of an n-III palsy. In 51 patients with diabetes I or II the height of the eyelid fissure was measured before and after topical application of 5% cocaine and 1:1000 adrenaline. The measurements were compared with those of a control group, patients with a peripheral Horner syndrome and patients with ocular myopathy.

No indications could be found for a sympathetic denervation as cause of the blepharoptosis. This concurred well with measurements of the pupil before and after topical cocaine and adrenaline.

The probability of a local myopathy caused by local ischemia in the m. levator palpebrae and/or m. tarsalis in diabetics with slight progressive blepharoptosis is stressed.

Key Words:

• blepharoptosis
• diabetes mellitus
• diabetic ptosis