What is ptosis

The expected outcome depends on the cause of the ptosis. In most cases, surgery is very successful in restoring appearance and function. In children, more severe drooping eyelids may lead to lazy eye or amblyopia. This may result in long-term vision loss.

Alghoul M. Blepharoplasty: anatomy, planning, techniques, and safety. Aesthet Surg J. PMID: pubmed. Diseases of the visual system. Goldman-Cecil Medicine. Philadelphia, PA: Elsevier; chap Cummings Otolaryngology: Head and Neck Surgery. Abnormalities of the lids. The problem could be: The brain or a nerve isn't working right. The nerves and the muscles have a connection problem.

The eyelid-lifting muscles are weak or missing. The eyelid muscle isn't attached to the eyelid properly. Sometimes, the eyelid doesn't open at all.

Ptosis can affect one eye or both eyes. What Problems Can Happen? A child with ptosis may: tilt the head back to see better say they have trouble seeing run into things hanging from overhead crawl or walk later than most children Children with ptosis often have other eye-related symptoms, including: eyes that don't line up nearsightedness, farsightedness, or astigmatism double, blurred, or distorted vision eye strain, headaches , or dizziness How Is Ptosis Diagnosed?

Doctors usually recommend more testing by: an eye specialist ophthalmologist. The ophthalmologist will check the child's vision, take special eye measurements, and look for any swelling that might be pushing the eyelid down. The neurologist will test the blood, nerves, and muscles to check for other problems. Avoiding the use of contact lenses and excessive eye rubbing, however, can reduce the risk of acquired ptosis. A paper , in the Journal of Clinical and Aesthetic Dermatology , notes that Botox injections, often by inexperienced injectors, are mostly connected to ptosis in aesthetic medicine.

Choosing a Botox injector with good experience will usually decrease the chances of eyelid ptosis when a person is receiving an injection for lines between the eyebrows. This droop is unnoticeable in many cases and does not cause pain. In other cases, a person may consider the condition has a negative impact on their appearance, and it may impact psychological well-being.

The eyelid may cover enough of the eye to impair vision in some cases, which may be worse when reading or looking downwards. It can also cause the eyebrow to raise to compensate for the visual block, which can tire the muscles in the face. Ptosis rarely causes discomfort or other health issues, so treatment is often not required. Treatment may be desirable for cosmetic purposes or to fix visual impairments. Surgery may be used to treat ptosis in specific cases.

The aim of this surgery is typically to tighten the levator muscle or repair the levator aponeurosis, which can help raise the eyelid. The procedure is safe, but complications are possible. In some cases, the surgery can undercorrect the problem. Overcorrecting is also a potential complication.

This leaves the eyelid either too high or too low and requires further surgery. The most common cause in children is when the levator palpebrae superioris does not develop well. This is present at birth and is called congenital ptosis.

Less common, the muscle can become weak later in life later in life causing acquired ptosis. Ptosis can involve one or both upper eyelids to various degrees, with or without symmetry Figure 1.

If the ptosis is mild it does not interfere with the visual development and does not require any treatment. An eye exam by a pediatric ophthalmologist is indicated to evaluate if the ptosis interferes with vision and if treatment is warranted.

These include myasthenia gravis, progressive external ophthalmoplegia, Horner syndrome, and third cranial nerve palsy. The ptosis may be combined with an eye movement disorder with resultant double vision. An eyelid mass can also cause ptosis. A complete eye examination is performed with special attention given to the history, to the eyelid position, vision assessment, refraction, and the head position.

Special tests such as radiographic exams x-rays or CT scans are not commonly ordered. Ptosis is treated by eyelid surgery.

It should be done as soon as there are signs of interference with the visual development.