This 27 year old man has had one droopy eyelid for as long as he can remember. He has also been told that he has one green and one brown eye. Childhood photographs confirm his history regarding the duration of symptoms. He does not suffer from headaches, does not smoke, has no history of head or neck trauma or surgery, and has no neurologic symptoms.
1. 1. How will his pupils respond to cocaine? Hydroxyamphetamine?
2. 2. Why might he hold a near card closer to his left eye?
3. 3. If the onset of these symptoms and signs were acute, what workup would be appropriate?
4. 4. Considering the results of the test pictured above, what is the most efficient surgical intervention?
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