Ptosis is the medical term for drooping of the upper eyelid. This lowering of the upper eyelid margin may cause a reduction in the field of vision when the eyelid either partially or completely obstructs the pupil.
Patients with ptosis often have difficulty keeping their eyelids open. To compensate, they will often arch their eyebrows in an effort to raise the drooping eyelids.
In severe cases, people with ptosis may need to lift their eyelids with their fingers in order to see. Children with ptosis may develop amblyopia («lazy eye») or developmental delay from the limitation of their vision.
Ptosis is not the same as the excess skin on the upper eyelid. The detection of a real Ptosis or droopy lid and its treatment must be performed only by an oculoplastic surgeon.
Doing a Blepharoplasty and not correcting an underlying Ptosis is one of the most common mistakes of surgeons that are not subspecialist in the delicate eye area.
When choosing a surgeon to perform ptosis surgery, look for a cosmetic and reconstructive facial surgeon who specializes in the eyelids, orbit, and tear drain system and who had extensive training in ophthalmic plastic reconstructive and cosmetic surgery.
Before and After
Upper Lid and Brow Ptosis Treatment shown below:
Ptosis Surgery and 4 Lids Blepharoplasty shown below:
Causes of Ptosis
There are many causes of droopy eyelids (ptosis) including age related weakening of the muscle, congenital weakness, trauma or sometimes neurologic disease. As we age, the tendon that attaches the levator muscle, the major muscle that lifts the eyelid can stretch and cause the eyelid to fall.
This represents the most common cause of a droopy eyelid. Ptosis may also occur following routine LASIK or cataract surgery due to stretching of the muscle or tendon. Children may be born with ptosis or may acquire it due to trauma or neurologic reasons.
Can Ptosis Be Corrected?
Droopy eyelids can be corrected surgically and usually involves tightening the levator muscle to elevate the eyelid.
In severe ptosis, when the levator muscle is extremely weak, a «sling» operation may be performed, enabling the forehead muscles to elevate the eyelid(s).
Other types of repair may include surgery on the muscle on the inside of the lid in cases of small amounts of ptosis.
The surgeon will perform testing determine the best form of correction for the individual patient. The goal is to elevate the eyelid to permit a full field of vision and to achieve symmetry with the opposite upper eyelid.