Ptosis, also known as blepharoptosis, is a drooping or falling of the upper eyelid. The drooping may be worse after being awake longer when the individual's muscles are tired. This condition is sometimes called "lazy eye", but that term normally refers to the condition amblyopia. If severe enough and left untreated, the drooping eyelid can cause other conditions, such as amblyopia or astigmatism. This is why it is especially important for this disorder to be treated in children at a young age, before it can interfere with vision development.

Signs and symptoms of Ptosis

The most obvious sign of ptosis is the drooping eyelid. Depending on how severely the lid droops, people with ptosis may have difficulty seeing.

Sometimes people tilt their heads back to try to see under the lid or raise their eyebrows repeatedly to try to lift the eyelids.

The degree of droopiness varies from one person to the next. If you think you may have ptosis, compare a recent photo of your face with one from 10 or 20 years ago, and you'll likely see a difference in the eyelid skin.

Ptosis can look similar to dermatochalasis, which is a group of connective tissue diseases that cause skin to hang in folds. These diseases are associated with less-than-normal elastic tissue formation.

See your eye doctor to determine the cause of your drooping eyelids.

Causes of Ptosis

Ptosis can be present at birth (congenital ptosis) or develop due to aging, injury or an aftereffect of cataract surgery or other corrective eye surgery.

This condition also can be caused by a problem with the muscles lifting the eyelid, called levator muscles. Sometimes a person's facial anatomy causes difficulties with these muscles.

An eye tumor, neurological disorder or systemic diseases like diabetes are other causes of drooping eyelids.

Ptosis Treatment

Surgery usually is the best treatment for drooping eyelids.

The surgeon will tighten the levator muscles so they can more easily lift the eyelids, giving you improved vision and appearance.

In very severe cases involving weakened levator muscles, your surgeon attaches the eyelid under the eyebrow. This allows the forehead muscles to substitute for levator muscles in lifting the eyelid.

If the condition occurs in a child, then the doctor will delay the surgery until the patient is 4 or 5 years old. If the patient is under the recommended age for surgery, then the doctor will test if occlusion therapy can compensate for the patient's impeded vision. The reason for delaying the surgery until the patient is at least 4-5 years of age is due to the delay for the frontonasal and upper face to complete their complex growth. After this complex growth is complete, the doctors will be able to obtain a more accurate measurement of the conditions. However, if the patient's vision impediment worsens or proves unresponsive to the occlusion therapy, then surgery will be needed sooner.

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Sarah Rose

Journal Manager Journal of Eye Diseases and Disorders

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