Eyelids and anterior segment: Case seven

Figure 1

Figure 2

This 50 year-old man has a long history of difficulty in opening his left eye (Figure 1). Figure 2 shows the appearance of the left eye when it is manually opened.

a. What physical signs are present and what is the most likely diagnosis?

b. What other ocular signs may be seen in this patient?

c. How successful is surgical correction of this condition?