Ptosis

introduction

What is Ptosis?

Ptosis is the drooping of your upper eyelid. It can affect both children as well as adults. Your eyelid may droop only slightly or it may droop so much as to cover the entire pupil (the hole in the colored part of your eye). It may affect one or both of your eyes.

Symptoms of Ptosis

  • The most obvious sign is a drooping eyelid
  • Increased watering
  • Depending on how severely your eyelid droops, you may even have difficulty seeing
  • Sometimes children may tilt their heads back or raise their eyebrows repeatedly to try and see under the eyelids
  • You may want to compare photographs from ten years earlier to see if you are looking sleepy or tired now

Causes of Ptosis

Ptosis may be caused by weakness of the muscles that raise your eyelid or damage to the nerves that control the muscles or the looseness of the eyelid skin.

Ptosis may be present at birth (called congenital ptosis). Or it may develop due to the normal aging process.

The most common cause in adults is a separation or stretching of the main muscle that pulls up the eyelid. It can be an after effect of an eye surgery like cataract or an injury.

An eye tumor, diabetes or neurological disorders like stroke, myasthenia gravis, and Horner syndrome are other causes.

Complications of Ptosis

  • An uncorrected drooping eyelid can lead to amblyopia (loss of vision in that eye)
  • An abnormal eyelid position can have negative psychological effects like poor self-esteem and alienation especially in teenagers and young children.
  • You may have headaches due to tension in your forehead muscles.
  • Decreased vision can affect your daily activities especially driving, using a flight of stairs etc.

Tests for Ptosis

Your doctor will do a physical examination to identify the cause. Special tests may be done for diabetes, myasthenia gravis, thyroid problems etc. These may include CT scans or MRI of the brain, MR Angiography, etc.

Treatment for Ptosis

If the Ptosis is caused by an underlying disease, treatment specific to that disease is given.
 
If you do not want to undergo surgery, you can have glasses made which have an attachment called a crutch. This crutch can help hold your eyelid up.

Surgery may be required for cosmetic purposes or if the ptosis interferes with vision. Eyelid Surgery is called Blepharoplasty.

Ptosis surgery involves tightening of the muscle that elevates the eyelid.

In severe cases, when a muscle called the levator is very weak, a sling operation may be done which will enable your forehead muscles to raise your eyelids.

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