The Differential Diagnosis and Classification of Eyelid Retraction

doi:10.1016/S0161-6420(96)30744-6

Ophthalmology

Volume 103, Issue 1, January 1996, Pages 168-176

https://doi.org/10.1016/S0161-6420(96)30744-6 Get rights and content

Background: Classification schemes are useful in the formulation of differential diagnoses. Thoughtful commentary has been devoted to the classification of blepharoptosis, but the causes of eyelid retraction have received less attention in published reports. Although eyelid retraction most frequently is associated with Graves ophthalmopathy, numerous other entities may cause the sign. This study was undertaken to provide a more comprehensive differential diagnosis and classification of eyelid retraction.

Methods: A series of patients with eyelid retraction was studied, and pertinent published reports were reviewed.

Results: Forty-four patients with different causes for eyelid retraction are described. Normal thyroid function and regulation were confirmed in all patients in whom Graves ophthalmopathy could not be excluded by clinical, biochemical, or historical criteria.

Conclusion: Based on a series of patients and reported cases, a differential diagnosis for eyelid retraction is proposed using a classification system comprising three categories (neurogenic, myogenic, and mechanistic).

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: Presented in part as a poster at the 1994 Annual Meeting of the American Academy of Ophthalmology, San Francisco, October/November 1994, and read at the One Hundred Thirty-first Annual Meeting of the American Ophthalmological Society, Hot Springs, Virginia, May 1995.

: Supported in part by a grant from Research to Prevent Blindness, Inc, New York, New York, by National Institutes of Health grant EYO-8039, Bethesda, Maryland, and by the Mayo Foundation, Rochester, Minnesota.

View full text

The Differential Diagnosis and Classification of Eyelid Retraction

Am J Ophthalmol

J Pediatr

Am J Ophthalmol

Am J Ophthalmol

Am J Ophthalmol

Am J Ophthalmol

Ophthalmology

Am J Ophthalmol

Lancet

Am J Ophthalmol

Am J Ophthalmol

Ophthalmology

Ophthalmology

Int J Radiat Oncol Biol Phys

Am J Ophthalmol

Ophthalmology

Ophthalmology

Ophthalmology

Am J Ophthalmol

Mayo Clin Proc

The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota

Trans Am Ophthalmol Soc

Benign transient downward gaze in preterm infants

Pediatr Neurol

Nuclear ophthalmoplegia, with especial reference to retraction of lids and ptosis and to lesions of posterior commissure

Brain

L'hypertonie unilatérale du releveur de la paupiere supérieure dans le syndrome de Basedow

Bull Soc Belge Ophtalmol

Retraction nystagmus and retraction of eyelids due to arteriovenous aneurysm of midbrain

AMA Arch Neurol Psychiatry

Pathologic lid retraction and lid position in neurology

Pretectal eyelid retraction and lag

Ann Neurol

Nervous control of eyelid function: a review of clinical, experimental and pathological data

Brain

Organic affections

Basedow-ähnliches Augensyndrom bei Enzephalitis

Klin Monatsbl Augenheilkd

The mechanism of lid retraction in Graves' disease

Clin Sci

A mid-brain syndrome following head injury

J Neurol Neurosurg Psychiatry

Lid-lag in the Guillain-Barn syndrome

Arch Neurol

Kleine beitrage zur neurologie des auges: II. Über den nystagmus der bulbi begleitende gleichartige bewegungen des oberen augenlides (nystagmus des oberlides)

Arch Augenheilkd

Gaze-evoked eyelid and ocular nystagmus inhibited by the near reflex: unusual ocular motor phenomena in a lateral medullary syndrome

J Neurol Neurosurg Psychiatry

Lid nystagmus evoked by ocular convergence: an ocular electromyographic study

J Neurol Neurosurg Psychiatry

Compulsive eye opening and associated phenomena

AMA Arch Neurol Psychiatry

Left hemiplegia and motor impersistence

J Nerv Ment Dis

Spastic eyelids: failure of levator inhibition in unconscious states

Arch Neurol

Congenital ptosis with peculiar associated movements of the affected lid

Trans Ophthalmol Soc UK

An unusual case of the Marcus Gunn syndrome

Trans Ophthalmol Soc UK

Trigemino-oculomotor synkineses

Neurologia