Discussions By Condition: I cannot get a diagnosis.

Left eyelid ptosis - Horner's syndrome or something else???

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: Anonymous
  • May 5, 2008
  • 02:42 PM

Hi everyone, I am writing from Bulgaria. I hope you will be able to help me with an advice about the possible cause for my problem. My neurologist has not come out with a diagnosis. Now I am not taking any pills or going to any medical tests and my problem is still there ...
I am 32. Two months ago I noticed that my left eyelid was droopy compared to the right one. The pupil of the same eye seems more constricted which is espcially noticeable in the evening.My left eyelid also looks kind of swollen and slightly red. I felt and still feel slight pain above my eye below the eyebrow, especially if I move the eye abruptly. The right eye on the opposite seems too opened with a much larger pupil, as if something is wrong with it too. I thought my eyes were tired as a result from working too much at the computer, about 8-10 hours a day for the last 4 years.
I went to an eye doctor, she said it might be Horner's syndrome but was not sure (doctors here are not used to using the cocaine drop test). I went to three more eye doctors, two of them said it was something I had before (one even mentioned congential muscle insufficient development) and that it was just an eyelid muscle problem which could be fixed with an operation. The fourth eye doctor said it might be Horner's syndrome. One drop of the sympathomimetic Visin lifts and wrinkles the eyelid, the eye seems more open compared to the other one while the other eylid seems to drop a little (without an eyedrop instilled in it).
I went to a neurologist and was sent to do various tests. my eye movement and vision is normal without diplopia. My thyroid gland hormones and ultrasound exam are normal, my brain CT and MRI with angiography ( without contrast) are normal too, except for an empty sella which they say is nothing to worry about. The dopler sonography of the neck and head showed no significant vessel stenosis. I had an x-ray and MRI of the neck with normal results, chest X-ray which showed peribronchitis. I had electromiography of two face muscles to exclude myastenia gravis, and the results showed no decrement e.g. no myastenia.
I was wondering whether I should do angiography with contrast???
My nose is stuffy all the time and I had a slight cold with herples simplex near my nose before I noticed my eyelid problem. I had a slight pain in my left ear but the doctor said it was not otitis media (I've had actute otitis media 9 years ago with transient loss of hearing). At the time of my cold I also had something like a painflul pimple in the ear. Another thing is that I always feel my neck and back stiff because of working office work but now I had inter-rib neuralgia symptoms with a very stiff neck which started four weeks ago and have almost disappeared now.
I was looking at old pictures and it turned out I have had a slightly smaller pupil and a slightly droopy eyelid before, it can be seen on pictures dating 7-8 year back but it was a very slight difference, almost unnoticeable; Now the left eye is very droopy, and the right one seems too open and agitated.
Surprisingly I found another picture of mine at five years of age and the situation seemed as it is now. My relatives do not seem to remeber about such problem. All pictures of me as a baby beforehand and as a student afterwards are normal, with perfectly symmetrical eyelids and pupils.
I was wondering whether this could have something to do with allergy or some infection in the nose, orbit and ear. (I have another painful pimple in my ear right now).
If you have any ideas please help !

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