Aponeurotic. **Explanation:** **Senile ptosis** (also known as Involutional ptosis) is the most common form of acquired ptosis in the elderly. **Why Aponeurotic is correct:** The primary pathology in senile ptosis is the **disinsertion, dehiscence, or stretching of the Levator Palpebrae Superioris (LPS) aponeurosis** from its attachment to the tarsal plate. This occurs due to age-related degenerative changes. Characteristically, these patients present with a **high or absent upper eyelid crease** and good levator function, as the muscle itself is healthy, but its "tendon" (aponeurosis) has slipped. **Why other options are incorrect:** * **Neurogenic:** Caused by nerve defects, such as 3rd Nerve Palsy or Horner’s Syndrome. Senile ptosis does not involve nerve dysfunction. * **Myogenic:** Caused by primary muscle disorders (e.g., Myasthenia Gravis or Myotonic Dystrophy). In senile ptosis, the LPS muscle fibers are typically normal. * **Mechanical:** Caused by the weight of a mass (tumor, edema, or chalazion) pulling the lid down. Senile ptosis is due to structural laxity, not added weight. **High-Yield Clinical Pearls for NEET-PG:** * **Clinical Sign:** A "high skin crease" is the hallmark of aponeurotic ptosis. * **Thinning of the lid:** The eyelid may appear thin, sometimes allowing the iris to be visible through the skin (due to LPS dehiscence). * **Surgical Management:** The treatment of choice is **LPS Aponeurosis advancement or repair**. * **Differential:** If ptosis is associated with miosis, think Horner’s; if associated with ocular motility issues, think 3rd Nerve Palsy.

Oculoplasty — MCQs

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Oculoplasty — MCQs

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