Eyelid Drooping & Ptosis
Ptosis is a condition characterized by a drooping of the eyelid. There are several causes of ptosis or a droopy eyelid. There are a number of causes of ptosis and with careful evaluation and diagnosis ptosis can often be minimized or eliminated with outpatient surgery to repair the eyelid.
About Ptosis or Droopy Eyelid
A common cause of ptosis is the presence of excess upper eyelid skin and prolapsed fat associated with aging that can mechanically weigh down the upper eyelid and cause it to droop. This is considered a functional ptosis, as long as the upper eyelid maintains a normal position and functions normally. When it is the actual eyelid that is drooping, whether or not is associated with excess upper eyelid skin, ptosis becomes the diagnosis.
A specialized muscle is responsible for elevating the eyelid. Over time, it can stretch or detach from its insertions and can allow the upper eyelid to maintain a lower posture when the eyelid is opened. In this instance, the normal upper eyelid crease may appear to have migrated upward. Patients with this problem may display strong contraction of their eyebrow muscles, giving them furrow lines. While most patients don’t realize that they are doing this, they may experience significant fatigue over the course of a day. Patients with this condition may appear chronically tired or angry. Not only can this affect a patient’s appearance, but it can also significantly impair the upper and peripheral visual field. The patient may not notice this, as the central vision, which is used for reading or driving, is not affected.
Other causes of ptosis are mechanical and may result from trauma or previous surgery or tumors of the eyelid depending on their location. A condition call Myasthenia Gravis may present as droopy upper eyelids. Strokes or other neurologic damage to nerves of the face and eyes may also present with or have an associated droopy eyelid. There are several other rare causes of droopy eyelids. When evaluating your ptosis, we might perform special measurements and tests including taking photographs and performing a visual field test. Visual field testing will assess whether the droopy eyelid is impairing the upper or peripheral visual field. If you are a candidate, surgical correction can be done on an outpatient basis.
About Congenital Ptosis
Another type of droopy eyelid is a congenital ptosis or a droopy lid that is present at birth.
When a child is born with a droopy eyelid, this is considered congenital ptosis. There are several causes of congenital ptosis and is sometimes can associated with other eye problems including misdirected or misaligned eye muscles. In many instances, the eyelid muscle that elevates the eyelid does not develop well. There is a spectrum of severity from very mild to very severe. When significant, the droopy eyelid can block the visual input to the child’s eye and impair the development of that eye and normal vision. The child may maintain an abnormal head posture in an attempt to see underneath the droopy eyelids. Your child’s pediatric ophthalmologist will evaluate the functioning of the eyes and eye muscles, and assess whether the associated ptosis is significant and requires correction. If surgical correction is deemed necessary, your child will have a consultation with our specialist who will then explain the possible approaches to the surgical correction of congenital ptosis, each guided toward severity and cause of the droopy eyelid. The eyelid surgery for correction of congenital ptosis may range from a simple tightening of the upper eyelid muscle if it has good function to even utilizing the brow muscles to elevate the eyelid. There are several ways of accomplishing this goal including the use of specialized materials and grafting techniques and if necessary we will guide you through this process so we can be helpful in achieving the best possible results.