What is the opposite Phenomenon of Ptosis?
Retraction of the upper eyelid, i.e. spasm of the Muller’s muscle in thyrotoxicosis due to sympathetic overactivity. Nerve supply of the upper eyelid : 1) Levator palpebrae superioris (LPS) – By IIIrd cranial nerve. 2) Mullers muscle – By cervical sympathetic. Test the power of LPS muscle or upper eyelid, or test for Ptosis : A) First step – Ask the patient to look upwards or elevate the upper eyelid voluntarily. B) Second step – Now push down the frontal belly of occipitofrontalis muscle of forehead by your left hand (it is done to eliminate its elevating action on the upper eyelid). Again ask the patient to look upwards. C) Third step – If the patient can elevate the upper eyelid, now you may apply little resistance by your right index finger over the upper eyelid and ask the patient to look upwards again. Compare with the other side. * If the patient can not elevate the upper eyelid voluntarily, it is useless to do the next steps.
