Schechter R J
Ann Ophthalmol. 1978 Oct;10(10):1324-8.
Two patients are presented with unilateral ptosis and contralateral lid retraction. The lid retraction disappears upon manual elevation of the ptotic lid. Each patient with this phenomenon would be expected to have a frank tropia, or monofixation syndrome and prefer to fix with the ptotic eye. Extraordinary innervation is transmitted to the levator of the ptotic eye and, since we believe the levators follow Hering's law, this excessive innervation is also transmitted to the contralateral levator. This results in lid retraction in the second eye. If the ptotic lid is manually elevated, levator innervation decreases and the contralateral lid retraction disappears. This previously unreported maneuver of manually elevating the ptotic lid is superior to patching the ptotic eye for a period of days, the previous method for demonstrating this phenomenon. These considerations are important in the evaluation of lid retraction, and in determining the nature and extent of corrective surgery.
本文报告了2例单侧上睑下垂及对侧眼睑退缩的患者。当手动提起下垂的上睑时，眼睑退缩消失。预计每例出现这种现象的患者都会有明显的斜视或单眼注视综合征，且更倾向于用下垂的眼睛注视。异常的神经支配传递到下垂眼的提上睑肌，由于我们认为提上睑肌遵循赫林定律，这种过多的神经支配也会传递到对侧提上睑肌。这导致对侧眼睑退缩。如果手动提起下垂的上睑，提上睑肌的神经支配减少，对侧眼睑退缩消失。这种之前未报道过的手动提起下垂上睑的操作优于之前用于证明这种现象的方法，即遮盖下垂眼数天。这些考量对于眼睑退缩的评估以及确定矫正手术的性质和范围很重要。
