ACUTE COLD UNILATERAL ISOLATED PTOSIS WITH RAPID RESPONSE OF HIGH DOSE OF STEROID

A 23-year-old female presented with acute onset left painless ptosis of 5 days duration. No other ocular or neurological symptoms were associated. Ophthalmological examination was free with noticed brisky pupil reaction. Both systemic and neurological examinations were free. CT and MRI imaging were free with no swollen levator or any extra ocular muscles. After showing no improvement over 5 days with no medications the patient started oral prednisolone in low dose 15 mg per day after one week no improvement detected then high steroid therapy 45 mg per day was given with marked improvement within couple of days. The same dose was prescribed for 5 days with gradual withdrawal over 2 weeks. The patient remains symptomless all over six months which is the follow-up period. Conclusion: Acute ptosis may indicate serious pathology or may be simple pathology with rapid improvement.