CL Induced Ptosis

Question 1

Signs:

Answer 1

Abnormally low position of upper lids to RGPs
Reduced VPA - bilateral if bilateral wear
Induced to CL removal technique, leading to disinsertion of the levator muscle

Question 2

Management

Answer 2

Low threshold for referral if can’t differentiate from emergency (e.g., 3rd nerve palsy, Horner’s)
Refer to GP if non-emergency, but can’t confirm CL is causation
Advise a different approach to CL removal
Scleral CL with Ptosis prop / spx with Ptosis prop
Refit if CLAPC indicated or identify other causative factors
Manage any CLAPC
Referral for possible surgery may be required (e.g., damage to levator palpebral aponeurosis)