Ptosis (drooping eyelid)

[Sue J]

1. Has anyone ever heard of ptosis (drooping eyelid) being a sign of a dive-related injury?

2. Does anyone know of a reason to keep s/o with ptosis from diving?

DS has an appointment with a neurologist but we're also trying to gather information. Physician does not think DS's slight drooping and slower reaction of one eyelid should prevent him from diving in the meantime but admits she knows very little about dive medicine.

 

[Web Monkey]

1. Has anyone ever heard of ptosis (drooping eyelid) being a sign of a dive-related injury?

2. Does anyone know of a reason to keep s/o with ptosis from diving?

DS has an appointment with a neurologist but we're also trying to gather information. Physician does not think DS's slight drooping and slower reaction of one eyelid should prevent him from diving in the meantime but admits she knows very little about dive medicine.

Disclaimer: I'm not a doctor.

Non-symmetrical facial features can be a sign of neurological problems, including DCS.

If this appeared after a dive, I'd recommend calling DAN (phone number at the top of the screen) immediately for a referral.

Terry

 

[Sue J]

Thanks Web Monkey.

My concern is that it might be a DCS issue.

DS recently came back from a 3-week liveaboard instructional program. At least one of his dives was deeper than I'd like. He thinks the ptosis has been present for months or years so it's possible it has nothing to do with diving. I have to admit I didn't notice it until it was pointed out by an MD.

DAN's medical info. hotlines operates during business hours and his neurology apt. is for next week so we won't have any hard info. until after the weekend. He's supposed to be diving tomorrow and he'd kill me if I needlessly prevented him from going. I did a quick web search on ptosis and couldn't find anything dive related. Does anyone have personal experience with this?

 

[gsk3]

The differential for ptosis includes some really bad stuff, as it's an indication of cranial nerve dysfunction, particularly if his pupil is "blown" (large and not constricting in response to light). Have you seen a doctor locally? Doesn't DAN have a 24/7 emergency number as well?

 

[Web Monkey]

DAN's medical info. hotlines operates during business hours and his neurology apt. is for next week so we won't have any hard info. until after the weekend. He's supposed to be diving tomorrow and he'd kill me if I needlessly prevented him from going. I did a quick web search on ptosis and couldn't find anything dive related. Does anyone have personal experience with this?

As far as I know, DAN's emergency # is is 24 hours.

Terry

https://www.diversalertnetwork.org/medical/emergencies.asp

Using the DAN Emergency Hotline
+1-919-684-4DAN (4326) Whenever you need help, DAN is there. DAN's medical staff is on call 24 hours a day, 365 days a year, to handle diving emergencies such as decompression sickness, arterial gas embolism, pulmonary barotrauma, or other serious diving-related injuries. Each year, DAN answers more than 2000 calls on the diving emergency hotline from its members and divers.
When you call the DAN Emergency Hotline:

• The number +1-919-684-4DAN (4326) is answered at the switchboard of Duke University Medical Center. Tell the operator you have a diving emergency. The operator will either connect you directly with DAN or have someone call you back at the earliest possible moment.
• DAN's medical staff may make an immediate recommendation or call you back after making arrangements with a local physician or the DAN Regional Coordinator. DAN Regional Coordinators are familiar with chamber facilities in their area, and because they're qualified in diving medicine, they can make recommendations about treatment.
• DAN's medical staff or Regional Coordinator may ask you to wait by the phone while they make arrangements. These plans may take 30 minutes or longer, as several phone calls may be required. This delay should not place the diver in any greater danger. However, if the situation is life-threatening, arrange to transport the diver immediately to the nearest local medical facility for immediate stabilization and assessment of his or her condition. Call DAN TravelAssist at 1-800-326-3822 at this time for consultation with the local medical provider.

 

[mts0628]

Thanks Web Monkey.

My concern is that it might be a DCS issue.

DS recently came back from a 3-week liveaboard instructional program. At least one of his dives was deeper than I'd like. He thinks the ptosis has been present for months or years so it's possible it has nothing to do with diving. I have to admit I didn't notice it until it was pointed out by an MD.

DAN's medical info. hotlines operates during business hours and his neurology apt. is for next week so we won't have any hard info. until after the weekend. He's supposed to be diving tomorrow and he'd kill me if I needlessly prevented him from going. I did a quick web search on ptosis and couldn't find anything dive related. Does anyone have personal experience with this?

Hi Sue:

First let me say I am not a Physician but I know a little about diving medicine through training and then through unfortunate experience. With that said, here's my take...

I think you'd be doing your DS (I think that means darling Son, yes?) a disservice if you did not stop him from diving unless you got the go ahead from a neurologist, Diving Medical Officer (Hyperbaric Physician), or at the least a representative from DAN.

There is no dive and I repeat no dive that is worth potentiating a possible preexisting diving injury. If you don't know for certainty that this condition is not from diving, then treat it as it is from a diving injury and have him abstain from diving until a professional clears him. This is the best thing you can do for him and is by no means needless.

And finally there is no, one last time, the best never to come again, dive as far as I'm concerned and I would not risk further potential injury just to dive. Sure he may dive and be fine, but then again, he may have worse symptoms after tomorrow. I'd hate to hear that (or hear that he chanced it and was ok- kinda' like Russian Roulette).

I hope this helps, I am not trying to scare you too bad, but please look after him wisely.

With sincerest regards,
Thomas

 

[gert7to3]

How old is DS? Has he ever had any eye surgery? Has he ever suffered any sort of facial nerve issues, such as Bell's palsy?

 

[Sue J]

DS (dear son) was seen by a pediatric neurology team Wednesday at [renowned big-city hospital].

They ruled out the scariest possibilities like brain tumor or stroke, and took blood tests for a number of other causes such as Lyme disease, but as of yet we do not have a definitive answer as to the cause of the ptosis. They found no evidence of any other weakness, injuries or eye issues. The attending neurologist, who turned out to be a diver himself (yeah!), cleared him to dive without restriction. This was the same opinion we had gotten from DAN a few days earlier.

All in all, good results. DS snagged his first bugs two days later!

Thanks to all those who responded.