Ptosis — Drooping Eyelid Surgery
Ptosis is a clinical term for a droopy eyelid in one or both eyes. The drooping may be minimal, or the eyelid can descend low enough to impair vision. While ptosis can be congenital and affect children, it more often occurs in adults and is a result of aging. At the Eye Institute at the Medical Center Clinic, we usually correct ptosis with eyelid surgery.
What are the symptoms of ptosis?
The most obvious sign of ptosis is a drooping eyelid. The condition is not painful, but can impact the patient’s vision. There are differences in ptosis in children and adults.
When a child is born with a drooping eyelid, he or she has congenital ptosis. The usual cause is a problem with the levator muscle, the muscle that lifts the eyelid. Beyond the drooping eyelid, another symptom in children is when the upper eyelid creases don’t line up evenly between both eyes. A child with ptosis may tip their head back, lift up their chin, or force their eyebrows up in an attempt to see better.
Ptosis in children can lead to other vision problems if it is not addressed. If the drooping is to a degree that it affects vision, the child can develop amblyopia (colloquially known as lazy eye). Ptosis can lead to better vision in one eye over the other. The child may even develop crossed eyes.
Ptosis in adults usually involves drooping eyelids and is not linked with other eye conditions.
What causes ptosis?
In children, ptosis is usually congenital and, as mentioned above, can lead to other problems if not addressed.
In adults, ptosis is usually the result of the levator muscle stretching or separating from the eyelid. This can be the result of simple aging, as the skin and muscles around the eyes become weaker. It can also be a side effect after an eye surgery such as LASIK or cataract surgery, which can stretch the eyelid. An eye injury can lead to eyelid drooping, as well.
How is ptosis treated?
Surgery is the common treatment for ptosis, as the condition usually won’t correct itself. In children, we’ll first weigh the age, the height of the eyelid, the strength of the eyelid muscles, and other factors. We may opt to treat a condition such as lazy eye first, by patching the other eye to make the “lazy eye” become stronger.
Surgery in children usually tightens the levator muscle or attaches the eyelid to other muscles that can help lift the eyelid.
Adult ptosis is usually the result of sagging or excess skin. Often, we may only need to make a small adjustment to the lid’s lifting muscle. In cases with excess, saggy skin, we basically perform a cosmetic procedure known as blepharoplasty to remove the extra skin and tighten the underlying muscles. In severe cases where the levator muscle has separated from the eyelid, we will reattach it.