Ptosis and the Abnormal Eyelid – Board-Style Questions

What this deck covers

ptosis and the abnormal eyelid in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Droopy since day one
2. Looking down
3. Choosing the operation
4. The winking baby
5. Four features together
6. The lighter eye
7. When the lights go out
8. Down and out
9. Not really drooping
10. Blurred before it is covered
11. Chin in the air
12. When to operate
13. A lump that grew
14. A gap in the margin
15. Touching the surface
16. A painless bead
17. After the operation
18. Crusts every morning

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: A nerve injured during a difficult delivery, The droop is congenital rather than recently acquired, Shortening of the lifting muscle from the front, Weakness that improves briefly after a period of rest, A dominant syndrome of short, narrow lid openings, A pigment change of no clinical importance, Weakness of the muscle that narrows the pupil instead, A droop present since birth, now noticed, A smaller eye on that side, so the lid sits lower, Complete blocking of the visual axis by the drooping lid, Stiffness of the neck from an injury, Discharge him, since no follow-up is needed, An infantile haemangioma weighing the lid down, The tear drainage duct at the inner corner of the lid.

Clinical pearls from this deck

• No crease and no movement: the muscle is faulty.
• A lagging lid on downgaze dates the droop to birth.
• Poor lifting power means suspend it from the brow.
• A lid that winks with chewing is jaw-winking.
• Four lid features and an affected parent: one syndrome.
• A pale iris dates Horner to the first year.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all ENT and ophthalmology case decks · pediatric reference values.