What is apraxia of the eye?

Apraxia of eyelid opening is defined as “nonparalytic inability to open the eyes at will in the absence of visible contraction of the orbicularis oculi muscle.”Abnormalities of eyelid function have been described in the literature as far back as 1907, where Lewandowsky described apraxia of eyelid closure.

How is apraxia of the eyelid opening treated?

Blepharospasm patients with apraxia of lid opening are treated by an upper myectomy associated with tightening of the levator tendon that raises the eyelids (aponeurotic ptosis repair). By tightening the tendon of the muscle that raises the eyelids, patients can more effectively open their eyelids.

How common is apraxia of eyelid opening?

Apraxia of lid opening (ALO) has been reported in 7%, 10%, and 55% of patients with blepharospasm.

What is eyelid closure?

Closure is characterised by a progressive narrowing of the palpebral fissure, in a zipper-like fashion, from the outer canthus to the inner canthus. This moving wave of closure serves to force aqueous in the inter-palpebral fissure toward the lacrimal puncta, thus aiding tear drainage.

Is there such a thing as apraxia of lid opening?

Apraxia of Lid Opening. Apraxia of lid opening (ALO) is an inability to initiate voluntary eyelid opening following a period of eyelid closure, with normal function at other times. Manual lifting of the eyelid often resolves the problem and the lid is able to stay open. ALO was first clearly described as a distinct entity in 1965 as “a…

Who was the first person to discover apraxia of eyelid opening?

While Schilder and Riese both described apraxias of eyelid closure and opening in 1927 and 1930 in neurology literature, Goldstein et al were the first to describe apraxia of eyelid opening in ophthalmologic literature in 1965.

Is the inability to perform a motor action an apraxia?

Strictly speaking, ALO is not truly an apraxia or “inability to perform a motor action to command despite both an adequate understanding of the action and the elementary ability to carry out.” [ 2]

What causes the inability to open the eyes?

Apraxia of eyelid opening can result from involuntary inhibition of levator function, prolonged contraction of the orbicularis, or both. The classic finding of inability to open the lids after closure is postulated to be caused by persistent contraction of the activated orbicularis oculi muscle.