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57 year old woman who complains "The lids are somewhat down"
Digital Journal of Ophthalmology 1997
Volume 3, Number 12
February 4, 1997
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Melanie Ryan-Graham, MD | Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
History: 57 year old French Canadian woman with ptosis for 10 years. She also has had an enlarged right pupil since her teens.

PMHx: Hypertension, rheumatoid arthritis
Meds: Xanax, Premarin, Provera, Methotrexate, Metoprolol, Calcium, Vitamin E
SHx: Non contributory
FHx: Paternal grandmother with ptosis
- No diurnal variation of ptosis.
- No diplopia.
- No symptoms of Giant cell arteritis
- No generalized muscle weakness
- Dysphagia (solids > liquids) for many years, requiring Heimlich maneuver on several occasions