Ptosis (blepharoptosis) is the abnormal lowering, or drooping of the upper eyelid. Ptosis impairs vision, and can cover the whole eye, and completely limit normal vision. Untreated ptosis can lead to other conditions, including amblyopia and astigmatism.
Ptosis in Children
Children can be born with ptosis (congenital ptosis), when they have a problem with the muscle that controls the eyelid (levator).
Children with ptosis will adapt their posture to compensate, and will often tip their head back in order to see better.
Childhood ptosis could also be a sign of other underlying eye conditions, and will need to be assessed by an eye specialist.
The doctor will usually wait until the child is 4-5 years old, before conducting corrective surgery.
Ptosis in Adults
Adult ptosis is called acquired ptosis, and is normally due to a stretched levator muscle. The main causes are ageing, and trauma to the eye.
Corrective surgery will be advised where the ptosis is affecting vision or appearance, and treatment will depend on the cause of the injury.
What are the types of ptosis?
Ptosis can be divided into two main categories, including congenital ptosis, which is present at birth, and acquired ptosis.
Neurogenic ptosis occurs when there is an issue in how the nerve controls the movement of the eyelid muscles, and is caused by the autoimmune disorder, myasthenia Gravis, Horner’s syndrome, and third nerve palsy.
Myogenic Ptosis includes any ptosis affected by levator or Muller muscle dysfunction.
Aponeurotic ptosis is the most common form of ptosis, and is generally found in elderly patients, and is mostly a result of old age.
Mechanical ptosis is caused by an increase of weight on the eyelid. This is normally when the eyelid is weighed down by a lesion, or heavy skin mass.
Neurotoxic ptosis is a serious medical condition, and requires urgent medical attention. It is normally a precursor to respiratory failure, and is often caused by snake bites, or botulism.
In most cases of pseudo ptosis, it is caused due to a loss of orbital (eye) volume, and not related to defects of the eyelid.
What are the causes of Ptosis?
Ptosis occurs when the muscle that controls the upper eyelid is not functioning well, causing the eyelid to droop. This deterioration of the muscle can be caused by old age, it may be genetic, or it can be caused by trauma to the eye. In many cases, ptosis may be a sign of more serious underlying eye conditions.
How can Ptosis be treated?
Depending on how well the eyelid muscles are functioning, and if there is no clear vision loss, then the doctor might decide to treat with non-surgical methods.
However, when the ptosis is affecting vision, or appearance, then eyelid surgery might be an option.
Under local anaesthesia, the surgeon will tighten the small eyelid muscle by either making a small incision on the upper eyelid, or by flipping the eyelid over, and restoring the muscle from underneath the eyelid.
Follow up visits are recommended to ensure the eyelid functions in a normal manner.
Ptosis Surgery At Westside Eye Clinic
Westside Eye Clinic is a specialist Ophthalmology practice located in Jamboree Heights near the Mt Ommaney Shopping Centre, in the Western Suburbs of Brisbane.
Dr Joseph Park is a Specialist Ophthalmologist (an Eye Doctor) who trained in Brisbane and undertook further studies at Moorfields Eye Hospital and Western Eye Hospital in London, United Kingdom.