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This 69-year-old man has had ptosis of the left upper lid since childhood. Recently he has experienced drooping of the right upper lid. He uses frontalis contraction to help raise the lids. This is obvious in the picture. Levator function was measured at 10 mm in the right and 2 mm in the left. Vision is 4/60 (20/300) in the right eye (with cataract) and is 6/36 (20/60) in the left after cataract surgery done two years earlier. He is in good health otherwise and the remainder of the eye examination is unremarkable. Ocular motility is normal.

1.	In addition to levator function noted above, additional information that would be useful is:
	a. corneal sensitivity b. Bell response c. presence of past pointing d. (a) and (b) e. none of the above
2.	The diagnosis in this case is:
	a. congenital ptosis, left eye, with levator dehiscence, both eyes b. third nerve palsy c. congenital fibrosis syndrome d. trachoma e. (b) and (c)
3.	Treatment would include:
	a. steroids b. bilamellar transfer surgery c. frontalis suspension d. levator resection or advancement e. (c) and (d)

For answers to the above, click here on or after May 11, 2010.