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This 11-year-old boy presents with a ptosis of the left upper lid.  The family says this has been present for as long as they remember.

1.	How would you proceed?
	a. take a careful history b. check vision and do a refraction c. check motility d.  observe the boy's appearance with either eye covered e. all of the above
2.	When the left eye is covered, the right upper lid assumes a normal position.
	a. This information does not help unless you know how the left upper lid responds with the right eye covered. b. The boy is likely to have pseudo ptosis. c. This makes you more likely to consider ocular myasthenia. d.  This information does not help much; you need to do more. e. none of the above
3.	The most likely eventual treatment would be:
	a. levator resection on the right to correct the ptosis when the boy is using both eyes b. a trial dose of steroid c. appropriate eye muscle surgery d.  frontalis suspension on the right e. none of the above

For answers to the above, click here on or after December 25, 2007.