Blood count and chemistries normal. There is no Marcus-Gunn pupil. There is severe ptosis of the right upper lid. There is poor adduction and elevation of the right eye, and the eye is out-turned. Confrontational visual fields and penlight eye exam normal.
Optic nerve is normal bilaterally.
Move the mouse pointer over the image to observe eye movements in different directions. Systemic exam is unremarkable. The left pupil dilates poorly in the dark. There is no Marcus-Gunn pupil. There is 2-3mm ptosis of the left upper eyelid.