Ptosis

Ptosis is the medical term for a noticeable droopiness of the upper lids.  It has many possible causes:

1. Age. This is the most common cause of ptosis.  The muscles that elevate the eye stritch and become thinned with age, resulting in a loss of muscle tone and an inability to raise the upper lid.  Ptosis affects both eyes, but often one appears worse than the other.  Eye surgery, such as cataract removal, may aggravate this from the condition.
2. Congenital. Noticed at birth or shortly thereafter, congenital Ptosis is produced by a developmental abnormality in the muscles that elevate the upper lid.  Three-quarters of the time it affects only one eye.
3. Injury. Automobile accidents in which passengers are hurled through the windshield often damage the delicate structures around and in the eye.  Lacerations, burns, and chemical injuries may also cause the droopiness.
4. Neurological diseases. These are rare but must be diagnosed properly to avoid unnecessary surgery until the timing is right.

Symptoms are functional as well as cosmetic.  Difficulty reading and driving are common complaints.  Raising the entire brow with the muscles of the forehead and scalp may cause headaches and eyestrain as well.

In newborns, this problem must be addressed and treated properly to insure normal maturation of the visual system and the avoidance of amblyopia (lazy eye).

Treatment is surgical, and there are a number of possible approaches.  The goal is to elevate the lid to match the other side with minimum scars and side effects.  The most discussed complication is “over-doing-it” with resultant inability to close the eye completely after surgery.  This creates a dry eye situation that may be difficult to manage.

In the age related form almost invariably the unoperated eye will appear lower after a successful repair of the first eye.  This is a bilateral condition, and this drooping in the unoperated eye is to be expected.  It also may require surgery.