Ptosis is laxity and sagging of the upper eyelid. The eyelid can sag a little bit or completely cover the pupil. In some cases, ptosis can impair or even block normal vision. It can show up in children or adults and can be treated surgically.
Ptosis can:
- Affect one or both eyelids
- Be hereditary
- Be congenital (present at birth)
- Appear at a later point of life
If a child is born with ptosis, the condition is cold congenital ptosis. Congenital ptosis is often caused by the weak development of the muscle, which lifts the eyelids, called an elevator muscle. This condition doesn’t usually improve by itself with time. With medium to heavy congenital ptosis, treatment might be necessary in order for normal development of eyesight. Ptosis can affect one or both eyelids. It can be congenital or appear later in life. For congenital ptosis asymmetry can occur on the upper folds of the eyelids.
Children with ptosis can often lift their chin or tilt their head backwards to see properly under the drooping eyelid or lift their eyebrows to try to open their eyelid. In time, those unusual positions of the head can cause deformations in the head and neck.
In adults, the most common reason for ptosis is the splitting of stretching of the ligament of the elevator muscle of the eye. This process can be a result of aging, after cataract surgery or other eye surgery or as a result of trauma.
Treatment of ptosis in adults
An ophthalmologist can determine the reason for ptosis and plan the best treatment. If treatment is necessary, it is usually surgical. Sometimes, a small patch to lift the muscles and move the excess skin around the eyes (called a blepharoplasty) can lift the eyelid enough. The more serious form of ptosis requires strengthening the levator muscle as well.
Treatment of secondary ptosis
In most cases, treatment for congenital ptosis is surgical. If there is amblyopy present, treatment is done with an eye cover, glasses or eye drops. To determine whether surgery is necessary and which procedure is the most suitable, your ophthalmologist will consider the following:
- The age of the child
- Whether one or both eyelids are affected
- The height of the eyelid
- The strength of the muscle to lift and close the eyelid
- The movement of the eye