. A treatise on diseases of the eye . he head backward. The position of the head, wrinkling ofthe forehead, due to contraction of the occipitofrontalis nmscle, archedeyebrow, and smooth surface of the upper lid are characteristic. Notinfrequently defective action of the muscles supplied by the third nerveaccompanies the ptosis. Cases of synchronous movements of the droop-ing lid and the lower jaw have been reported by a number of the mouth is opened the lid raises; also in some cases in lateralmovements of the lower jaw, Epicanthus is sometimes associated withit (see page 15()).
. A treatise on diseases of the eye . he head backward. The position of the head, wrinkling ofthe forehead, due to contraction of the occipitofrontalis nmscle, archedeyebrow, and smooth surface of the upper lid are characteristic. Notinfrequently defective action of the muscles supplied by the third nerveaccompanies the ptosis. Cases of synchronous movements of the droop-ing lid and the lower jaw have been reported by a number of the mouth is opened the lid raises; also in some cases in lateralmovements of the lower jaw, Epicanthus is sometimes associated withit (see page 15()). Etiology.—In many cases the condition is i\\\v to j)artial destructionof the nucleus of the third nerve. Insufficient devel{)])ment or absenceof the levator palpebrse superioris is supposed to be the cause in somecases. Other muscles supplied by the motor oculi may be in the cortical centre for the elevation of the lid, which, accordingto Lodata, lies in the sigmoid gyrus of tli{> opposite side, wlictiicr con-. Arch, of Ophtli., vol. iii, p. , Centralbl. f. prakt. Augenh. ?i Med. isJi;, p. is<j. 189G, p. 7. 158 THE EYELIDS genital or acquired, may cause ptosis. Hysteria is apparently sometimesthe cause of transient ptosis. Abadie^ reports two cases. Treatment.—This is always surgical (see chapter on Operations). Distichiasis.—^This condition is characterized by a malpositionof the cilia, other parts of the lids being normal. The cilia, whichnormally are present in two or three rows, are present in distichiasis infour or five rows throughout part or whole of the lid margin; some orall of the inner one or two rows, which are often very much smaller thanthe outer rows, are directed against the eyeball. The friction of theevelashes against the cornea and conjunctiva produces much irritation,which can only be relieved by their removal. Treatment.—See Trichiasis and Entropion. Dermoid Tumors.—They are probably always congenital
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