Ptosis


What is Ptosis?

Ptosis is the medical term for a sagging or drooping eyelid. It may be present in either one or both of your eyelids, causing you visual problems. It can improve and worsen during different times of the day, often worsening when you are tired or stressed. The main problems associated with ptosis are both the loss of the upper visual field and the poor cosmetic appearance. Damage to the surface of the eyeball, namely the cornea, is also a problem as it can cause long lasting vision difficulties.

Types of Ptosis

There are three main forms of ptosis. Congenital ptosis is present from birth and if left untreated can cause loss of vision in the affected eye. The second type of ptosis is so called ‘acquired’, meaning you have developed it at sometime in your life. This is usually due to damage of the muscles that control your eyelid. The final type of ptosis is ‘pseudoptosis’, meaning you have the symptoms of ptosis, but they aren’t due to problems with the muscle. This condition is usually attributed to excess amounts of eyelid skin.

Causes of Ptosis

The levator palpebrae superioris muscle is responsible for raising your eyelid, which is important when blinking. Any type of damage to this muscle or the nerve that controls it can leave you with the symptoms listed below. The main form of ptosis is myogenic or muscular in origin, often due to damage that occurs with old age or rarely after cataract surgery. Other causes include nerve problems such as Horner’s syndrome due to nervous system damage and even due to snake bites.

Symptoms of Ptosis

The main symptom you would notice is a droopy eyelid, however you may experience problems such as irritation or soreness, double vision or diplopia, nausea and neck pain from tilting your head back. You may notice that your child begins to tilt their head back to see better, or tries to raise their eyelid by raising their eyebrows. If you notice any of these symptoms you should make an appointment to see your family GP.

Treatment for Ptosis

It is very rare that ptosis will spontaneously resolve, it is almost certain that if affected you will require some form of corrective surgery. First the cause of the ptosis must be determined, before treatment can be started. Problems due to nervous system and muscle conditions must be treated before corrective surgery can be suggested. The corrective surgery involves shortening the levator muscle that controls the upper eyelid. This prevents the eyelid from drooping down so much. It is also necessary for the eye surgeons to correct the position of the eyeball, a problem that often occurs along with ptosis.

Following surgery your eye will be kept closed for a period of weeks, allowing the muscle to heal and the swelling to subside. Many patients report extremely good visual and cosmetic outcomes.

Visit the Blepharoplasty (Eyelid Surgery) Guide for further information.

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