Author Affiliations Baylor College of Medicine, Houston, Texas.
A 64-year-old woman with no visual or systemic symptoms consulted for a cosmetic procedure on her right eyelid that had been progressively drooping for 3 months (Figure 1). Ocular examination was significant for dilatation lag in the right pupil and an anisocoria, with the right and left pupils measuring 1.5 mm and 3.5 mm, respectively. The right pupil failed to dilate with 4% cocaine drops but dilated with 1% hydroxyamphetamine drops. Mild right facial flushing but no impaired sweating was detected clinically. Systemic examination was significant for a right-sided neck fullness that moved upward with swallowing.
Anand A, Negi SI. Right Eye Droop. Arch Neurol. 2012;69(11):1516. doi:10.1001/archneurol.2012.217