Complete post-traumatic ptosis: a mechanism for recovery?

Traumatic blepharoptosis, although considered relatively rare, is an entity which demands recognition if one is to achieve optimal results. Reports of levator injury following orbital, ocular, and adnexal surgery, as well as in cataract and blepharoplasty procedures, are well described. In most cases eventuating in complete ptosis, levator disinsertion is the anatomic correlate, the ptosis is usually permanent, and surgical intervention is often indicated. We have observed two cases of transient, complete post-traumatic ptosis which have recovered by 6 weeks with expectant management. We believe this entity to be more pervasive than the current literature seems to reflect and emphasis is placed on nonoperative therapy. This paper reviews the anatomical considerations relevant to the function of the levator complex as well as the possible mechanisms for its injury.