Ma'am could you please explain abt Herings law in case of bilateral ptosis After correction of ptosis in one eye in bilateral cases why there will be drooping ? Shouldn't it be retraction Thank u ma'am
“The levator muscles obey Hering’s law of equal innervation and hence are innervated symmetrically, resulting in equal central neural output. In cases of bilateral asymmetrical ptosis, the less affected eyelid may maintain a normal level of elevation due to excessive innervational stimulation determined by the more ptotic eyelid. This condition can be detected prior to surgery by manually elevating the ptotic eyelid. An immediate fall of the contralateral eyelid confirms the presence of bilateral, asymmetrical ptosis masked by levator ‘overaction.’” I have quoted the above from “Utheim, T. (2014). Pathobiology of Human Disease || The Eyelid. 2201-2215” So here correction of ptosis is equivalent to lifting of the eyelid. If you lift the ptotic lid, there is a decreased requirement for that lid to remain elevated, this ↓ innervation also flows to the contralateral lid, which then droops a little. Does that answer your question?
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Ma'am could you please explain abt Herings law in case of bilateral ptosis
After correction of ptosis in one eye in bilateral cases why there will be drooping ?
Shouldn't it be retraction
Thank u ma'am
“The levator muscles obey Hering’s law of equal innervation
and hence are innervated symmetrically, resulting in equal
central neural output. In cases of bilateral asymmetrical ptosis,
the less affected eyelid may maintain a normal level of elevation due to excessive innervational stimulation determined by the more ptotic eyelid. This condition can be detected prior to surgery by manually elevating the ptotic eyelid. An immediate fall of the contralateral eyelid confirms the presence of bilateral, asymmetrical ptosis masked by levator ‘overaction.’”
I have quoted the above from “Utheim, T. (2014). Pathobiology of Human Disease || The Eyelid. 2201-2215”
So here correction of ptosis is equivalent to lifting of the eyelid. If you lift the ptotic lid, there is a decreased requirement for that lid to remain elevated, this ↓ innervation also flows to the contralateral lid, which then droops a little. Does that answer your question?
@@ophthalmologypearls thank u so much
It's clear now
Nobar