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Droopy Eyelids (Ptosis) – Symptoms, Causes and Treatment

Droopy Eyelids The drooping of the upper eyelid is medically termed ‘ptosis’ and is pronounced toe-sis. The condition is usually caused by a weakening of the levator muscles, which are responsible for raising the eyelid, but it can also be due to a problem with the nerve that send messages to these muscles. The droopiness may be barely discernible, or the eyelid can be almost fully closed, covering the pupil.

Symptoms of ptosis
Symptoms may include some or all of the following:

  • Drooping eyelid (may affect one or both eyes)
  • Irritation and/or tearing
  • Difficulty closing the eye completely
  • Eye fatigue from straining to keep eye(s)open
  • Double Vision (Diplopia)
  • Child tilts their head back or raises their eyebrows to see clearly

A good way to check your own eye is to compare recent photographs of your face with those taken 10 or 20 years ago. Check for differences carefully to detect signs of lower or drooping eyelids.

Causes of ptosis
Ptosis is either congenital (present at birth) or can happen later in life as a result of aging, disease, injury or as a side effect of eye surgery. Sometimes a person’s facial anatomy makes them particularly prone to the disorder. An eye tumor, neurological disorder or a disease, such as diabetes, can also cause drooping eyelids.

Ptosis can sometimes appear similar to dermatochalasis, a common condition where the skin hangs in folds due to a lack of elastic tissue.

Treatment of ptosis
When examining a patient with a drooping eyelid, the doctor will measure the height of the eyelid, test the strength of the muscles and evaluate the alignment and movement of the eye. The usual treatment for drooping eyelids is surgery, which is called ‘blepharoplasty’. The surgeon can tighten the levator muscles to lift the eyelids, improving both vision and appearance. In severe cases of weak levator muscles, the eyelid can be attached under the eyebrow, allowing the forehead muscles to substitute for the levator muscles. Surgery is usually done under local anesthetic, except with young children.

Ptosis in children
Children born with moderate or severe ptosis require early treatment to ensure their vision develops properly. If it is not addressed early enough, amblyopia (“lazy eye”) may result, possibly leading to a lifetime of poor vision.

Children should have eye tests at several stages of their development and even mild cases of ptosis should be monitored yearly. The eye will change shape as the child grows and develops, and focusing and vision problems may occur if the ptosis worsens.

Unfortunately ptosis does not improve by itself and almost always requires corrective surgery at some stage.

Complications from eyelid surgery
The eyelids may not appear symmetrical after surgery. It is also possible that eyelid movement may be lost, however this complication is rare. Dry eye may occur if the lifted eyelids do not close completely.

Complications are more likely to occur with an inexperienced surgeon, so you must choose your doctor carefully. When you are interviewing a potential candidate, ask how many procedures he or she performs per week. You should also ask to see before and after pictures of previous surgeries, and find out if there are any former patients you can speak with about their experience.

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