Brief Answer:
Rule out myasthenia gravis

Detailed Answer:
Hello,
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I have gone through your question and seen the attached picture.
The main concern with intermittent drooping of eyelids is myasthenia gravis. The drooping will be predominant in evening hours.
Myasthenia gravis is a disorder of neuromuscular junction, where autoantibodies block the acetyl choline receptor at neuromuscular junction.Muscles will have progressive fatigue with repetitive use and regain normal function with rest.

Physical examination, blood investigations to check acetyl choline receptor antibody levels, tension test(conducted by injecting tension and watching for response), Elextromyography, nerve conduction studies and Chest Xray(to look for enlarged thymus seen in myasthenia gravis) are required to confirm the diagnosis.

Management of myasthenia gravis is with acetyl choline esterase inhibitors, immunosuppressive therapy and thymectomy.

Please be advised to follow up with your primary care provider for further evaluation and management.

Hope this answers your question
Please address further questions here
Regards
Dr.Lekshmi

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