Both patients have Covid. Covid has returned. After a summer relatively free of Covid patients, we now see Covid patients everyday. Be safe, be wary. Winter is here.
My approach to ptosis is: NMJ disease, third nerve palsy, or Horner’s syndrome? Is there a medial gaze palsy or diploplia? Is there miosis – anhidrosis? What happens if I do the ice test (for myasthenia)?
The ddx and work-up for ptosis is far more complex than this simple 1-2-3 approach. Most patients will need a neurologist and neuro-imaging. Sometimes, all they need is a CXR (can you guess why?). In general, ptosis is not an emergent problem like an acute MI, but most patients will require an admission to get an answer.