Date of last review: Due to be updated

Differential diagnosis

  • Ptosis
    • Involutional ptosis
  • Strabismus
    • Myasthenia gravis
    • Thyroid eye disease
    • Myositis
    • Chronic progressive external ophthalmoparesis

Possible management by Optometrist

Treatment

  • None

Advice

  • Refer urgently to ophthalmology

Management Category

  • Urgent referral to ophthalmology

Possible management by Ophthalmologist

  • Urgent CT angiography to rule out posterior communicating artery aneurysm
  • Address vascular risk factors for arteriosclerotic infarction of the vasa vasorum (microvascular blood supply) of the third nerve
    • Smoking status
    • Alcohol
    • Diet
    • Exercise
    • Blood pressure
    • Diabetes