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E ditor ,-Involuntary closure of the eyelid can be due to either a ptosis with dysfunction of the levator muscle, or a form of blepharospasm with exaggerated contraction of the orbicularis muscle. In true ptosis, no lid crease can be observed in the upper eyelid, whereas in (essential) blepharospasm or (secondary) pseudoptosis a lid crease is present. 1 We report a case of involuntary intermittent eyelid closure secundary to an exophoria.
CASE REPORT
A 67 year old man had complained for 3 years that his left eyelid seemed to fall down and close spontaneously several times a day, and with increasing frequency. This happened especially when he was at home quietly watching television or when he was talking to someone, which made him feel embarrassed. He was able to open the eye again voluntarily, if he paid attention. The eyelid closure never occurred when he was driving a car. Also, when he closed his right eye, he could keep the left one open without any problem. When spontaneous eyelid closure did occur, he sometimes had double vision for a very short while. It had also been noted by his wife that his left eye deviated outward sometimes.
The patient had been known to have hypertension for 20 years and had been treated with medication by his family physician; 6 months before his first visit to our department a light form of diabetes mellitus type 2 had been diagnosed.
When the complaints started 3 years earlier, the patient was seen by a neurologist in a peripheral medical...