Eyelid: ptosis: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Eyelid: ptosis

Sample item

A newborn has drooping of the right upper eyelid, which retracts briskly when the baby sucks or moves the jaw to the left. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Marcus Gunn jaw-winking syndrome

Marcus Gunn jaw-winking is a congenital synkinesis in which the levator palpebrae superioris is abnormally innervated by branches of the trigeminal (pterygoid) nerve, so the ptotic lid lifts on chewing or jaw movement to the opposite side. Treatment depends on the degree of ptosis, to prevent amblyopia and improve appearance.

Option by option

  • A. Myasthenia gravis

    Myasthenia gravis causes fatigable ptosis that is not linked to jaw movement.

  • B. Horner syndrome

    Horner syndrome gives mild ptosis, miosis and anhidrosis without synkinesis.

  • C. Marcus Gunn jaw-winking syndrome (correct)

    Correct. Lid elevation with jaw movement is characteristic.

  • D. Third nerve palsy

    Third nerve palsy gives ptosis with an eye deviated down and out.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is C, Marcus Gunn jaw-winking syndrome. Marcus Gunn jaw-winking is a congenital synkinesis in which the levator palpebrae superioris is abnormally innervated by branches of the trigeminal (pterygoid) nerve, so the ptotic lid lifts on chewing or jaw movement to the opposite side.

Why is "Myasthenia gravis" not the answer?

Myasthenia gravis causes fatigable ptosis that is not linked to jaw movement.

Why is "Horner syndrome" not the answer?

Horner syndrome gives mild ptosis, miosis and anhidrosis without synkinesis.

Why is "Third nerve palsy" not the answer?

Third nerve palsy gives ptosis with an eye deviated down and out.

What concept does this question test?

It tests Eyelid: ptosis in Ophthalmology. Treatment depends on the degree of ptosis, to prevent amblyopia and improve appearance.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Eyelid: ptosis?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.