Isolated left upper eyelid ptosis with pansinusitis and contralateral otitis media in a 9-year-old boy

PURPOSE: Upper eyelid ptosis has different etiologies in children and adults. In children, the common causes include orbital cellulitis, congenital ptosis, Cranial Nerve (CN) III palsy, and Horner's syndrome. The purpose of this report is to discuss an unusual presentation of ptosis. OBSERVATIONS: We describe a case of a 9-year-old boy with left-sided ptosis with no apparent clinical signs of orbital or preseptal infection. Magnetic resonance imaging (MRI) revealed pansinusitis and contralateral otitis media with direct extension into the superior aspect of the left orbit affecting the levator palpebrae superioris muscle. CONCLUSIONS AND IMPORTANCE: This finding on imaging disclosed the etiology of an otherwise unexplained case of upper lid ptosis.