Blepharoptosis after traumatic third-nerve palsies.

We evaluated the clinical records of 16 patients with blepharoptosis secondary to direct traumatic third-nerve palsies. Most patients were involved in auto accidents, and had associated skull fractures. Of 12 patients who were followed up for at least one year, ten recovered completely. Over half of the patients had evidence of aberrant regeneration, which could be seen clinically as early as nine weeks after the trauma. Orbital localization of the third-nerve dysfunction carries an excellent prognosis for prompt, spontaneous recovery without aberrant regeneration. Surgical intervention in these cases should be delayed at least one year after the traumatic event, and longer if continued slow but progressive recovery is demonstrated.