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Upside Down Ptosis
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Upside Down Ptosis

Is there anything other than Horner's Syndrome that can cause reverse or upside down ptosis?

The lower lid on my right eye is clearly raised higher, and I also have some mild drooping.  My husband thinks my eye looks smaller and sunken in, but I think that's just an illusion from the ptosis. This came on overnight about a month ago.  It varies in intensity.  Tests for MG were negative. My vision is OK, except for losing some peripheral probably due to the droopy lid. I've had no injuries or  infections.  I can raise my eyebrow on the bad eye and made the upper eyelid ptosis almost 'disappear'.   I've seen an ophthalmologist who has referred me to a neurologist.

When I look for info on reverse ptosis, all I find is Horner's.  Are there any other conditions associated or is this symptom pretty specific?

Thank you so much.
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Dear MidwesternMom,

The neurologist or neuro-ophthalmologist should be able to assist in making the appropriate diagnosis.  Further testing may be required.  A complete history and examination is needed.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California
2 Comments
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Just an update... I'd still be interested in hearing an answer to my original question, if anyone knows.


Neurologist called this probable horner's based on symptoms.  The oddity is how symptoms vary in degree from one day to the next.  Next step is an MRI and MRA (of the brain).

I'm not too worried, I think this could even be related to some pituitary issues (perhaps a small non-cancerous tumor on the pituitary) that I am going to see an endocrinologist for. Hopefully things will be figured out soon.
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