ABNORMALITIES OF EYELID POSITION: ANALYSIS OF CASES SEEN IN AN URBAN HOSPITAL IN NIGERIA

Abstract

Aim: To determine the types, causes and relative frequencies of abnormal tonic eyelid position in 
patients seen at the eye clinic of the University of Benin Teaching Hospital.
Method: A review of the case files of all new patients presenting with abnormal tonic eyelid position 
was done. Data on age, gender, laterality, type and aetiology of abnormal tonic eyelid position was 
obtained.
Result: There were 109 patients with abnormalities of tonic eyelid position. These included 51 males 
with a male: female ratio of 1:1.1. The age range was from 6weeks to 87years; mean age 37.6years (SD ± 
23.9). There was unilateral involvement in 88 (80.7%) cases. Abnormalities of tonic eyelid position were 
ptosis 77 (70.6%), lagophthalmos 22 (20.2%), facial spasm 7 (6.4%) and lid retraction 3 (2.8%). The most 
frequent cause of ptosis was oculomotor nerve palsy while blepharospasm was the most frequent cause 
of facial spasm. Seventh nerve palsy was the most frequent cause of lagophthalmos while the three 
cases of lid retraction were seen in patients with thyroid eye disease.
Conclusion: Neurological and other debilitating illnesses were common causes of abnormal tonic eyelid 
position. Examination of the eyelid for tonic position should not be overlooked during ophthalmic 
evaluation.