A 62-year-old woman was told that her left eyelid remained open when she looked downward as well as when she slept. Soon afterward, pain and weakness developed in her right leg. On admission 2 months later, her eyelids were symmetrical on forward gaze (the left eye was slightly lower), but the left upper eyelid elevated minimally on upgaze, failed to descend on downgaze, and did not relax on eyelid closure (Figure). Proptosis was absent, eye movements were full, and neither orbital pain nor diplopia occurred.
Keane JR. Fixed Eyelid Due to Metastatic Breast Cancer. Arch Neurol. 2005;62(2):327. doi:10.1001/archneur.62.2.327