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Ptosis: Causes, Symptoms And Treatments

Adult with ptosis

Ptosis is the medical term the drooping of upper eyelid, either in one or both eyes.

It can occur in both children and adults, but usually happens due to aging. 

Severity of this condition is measured by the amount of droopiness the condition exhibits.

Whether the droop is slightly (barely noticeable) or completely covering the entire pupil.

And whether it is hindering normal vision.

This condition is not to be confused with Dermatochalasis.

A condition in which vision is blocked due to excess skin overlapping the eye.

Check with your eye doctor whether your condition is drooping eyelid or dermatochalasis.

They should be able to differentiate.

Generally ptosis is classified as congenital if eyelid drooping is already presented at birth or acquired; if it develops later.

Symptoms Of Ptosis

If your child is exhibiting the symptoms below, he or she might be suffering from ptosis.

  • Eye fatigue
  • Increased tearing
  • Drooling of upper eyelid
  • Tilting of head in chin up position
  • Consistent raising of eyebrow in attempt to lift eyelid
  • Attempt to see properly by lifting up the eyelid with a finger
  • Eyestrain and headache due to continuous squeezing of forehead

What Causes Drooping Eyelid?

Congenital ptosis is often caused by poor development of the muscle that lifts the eyelid, the levator muscle.

The causes of the poor development is not yet understood. Some scientists believe it to be a hereditary factor.

In adults, the most common cause of eye drooping is by the weakening or separation of the levator muscle.

This process may occur as a result of aging, contact lens wear, head injury, complications after cataract surgery or corrective eye surgery.  

Sometimes, tumour, diabetes or a neurological problem which affect the nerves and/or muscles of the eye, such as Horner's syndrome, stoke, nerve palsy, myasthenia gravis or muscle weakness (myopathy) can cause drooping of the eyelid too. 

Ptosis And Children

Child with ptosis

It is important for children with mild or severe drooping eyelid to get treatment as early in order to develop normal vision. 

When the eyelid is constantly covering the eye, astigmatism can develop due to the compression of the droopy eyelid.

This causes blurry visual images and over time, it can lead to lazy eye (amblyopia) as the brain starts to ‘turn off’ confusing inputs from the drooped eye.

Lazy eye can cause eventual blindness if no early intervention is taken.

Drooping eyelid can also hide misaligned or crossed eyes (strabismus), which can cause lazy eye.

Treatments For Drooping Eyelids

Blepharoplasty (eyelid surgery) may be the best treatment for drooping eyelids in prompting better vision and improving cosmetic appearance. 

During eyelid surgery, local anesthetic drops are placed on the eye and the upper eyelid to numb them.

A small incision is made into the eyelid and the levator muscle (eyelid lifting muscle) is located and tightened. 

In severe cases of drooping eyelids involving very weak levator muscle, your surgeon will attach the eyelid under the eyebrow using dissolving sutures.

This allows your eyelid to be lifted by the forehead muscles instead of the weakened levator muscle. 

If lazy eye is presented, further treatment may include patching or dulling the normal eye with eye drops to strengthen the weaker one. 

Risks Of Eyelid Surgery

As with all other surgeries, eyelid surgery can incur serious risks. Make sure you discuss with your eye surgeon about the potential risks before going for the surgery.

  • Infection in the eyelid
  • Uncontrolled bleeding
  • Lost of eyelid movement
  • Eyelids not appearing symmetrical
  • Bruising and swelling of the eyelids
  • Undercorrection (lid too low) or overcorrection (lid too high)
  • Dry eyes if uplifted eyelid is incapable of closing properly. If its temporary, lubricating drops and lotions may help
  • Sometimes if the other eye has a tendency to drop, this may become more noticeable after eyelid surgery on one side

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