Aponeurotic ptosis due to playful lid eversion: Case report and literature review

Abstract

Aponeurotic ptosis is known to occur due to a wide variety of causes that lead to dehiscence of levator aponeurosis from the tarsal plate. We report here two cases with an unusual mechanism, resulting in this type of ptosis. Both the cases presented with spontaneous progressive drooping of upper lids, more on the right side, and gave a history of repeated playful eversion of upper lids. The first case underwent successful levator palpebrae superioris aponeurosis reattachment. Peroperatively, disinsertion and thinning of aponeurosis confirmed the diagnosis. Repeated habitual eversion of lids had probably caused stretching and mild chronic inflammation of the tarsus and lid retractors, leading to progressive thinning with disinsertion of the levator aponeurosis.

Keywords

• levator palpebrae superioris reattachment
• levo aponeurotic ptosis
• lid eversion
• ptosis