Abstract

Acquired isolated unilateral or bilateral blepharoptosis has many aetiologies. When pupils are normal, a myasthenic syndrome or a myopathy have to be ruled out. If the tests for myasthenia gravis are negative, the next step is to perform a muscle biopsy in order to establish a diagnosis. Muscle examination may show a mitochondrial disorder, non specific abnormalities or be quite normal. We have single out three patients, previously submitted among various investigations also to a muscle biopsy, whose lid ptosis disappeared by using eyedrops containing naphazoline nitrate, a sympatomimetic drug, thus suggesting a partial Horner’s syndrome. We emphasize the usefulness of this simple and cheap test before performing more traumatic and expensive investigations.