What is a ptosis?
Ptosis is a drooping or lowering of the upper eyelid that can affect either one or both eyes. The droop may be barely noticeable, or it may cause the upper eyelid to descend over the entire pupil. Depending on the severity of the ptosis, people may have difficulty in seeing due to the drooping eyelid restricting their field of vision. Ptosis can occur due to a number of causes, but the majority of cases are caused by age related changes in the upper eyelid and can be improved with surgery. Being examined by an experienced oculoplastic surgeon will ensure that the correct treatment is chosen for you.
What are the symptoms of ptosis?
The most obvious sign of a ptosis is the drooping of one or both eyelids. People with a ptosis may have difficulty in seeing depending on how low their upper eyelid rests. To reduce the effects of a ptosis, people sometimes raise their eyebrows, tilt their head back, to try to see under the lid, or manually lift their eyelids using their fingers.
Ptosis can resemble dermatochalasis (excess upper eyelid skin) as this can also cause the upper eyelid to droop or sag. The causes of these two conditions are different, and a correct diagnosis and management plan can be made during a consultation with an expert oculoplastic consultant.
What causes ptosis?
Ptosis can be caused by a weakness or stretching of the levator muscle in the upper eyelid which usually works to lift the lid. Ptosis can be present at birth (congenital ptosis) or it can occur as part of the normal ageing process. Other causes, such as injury, other eye surgery, autoimmune disease, neurological disease or systemic disease, can also cause ptosis to occur.
What are the treatments for ptosis?
Treatment for ptosis depends on its cause and severity. If the ptosis is congenital or due to the natural ageing process, it may be recommended that you do not have surgical treatment however you may wish to undergo an operation for cosmetic purposes.
If the ptosis is caused by an underlying health condition, then treatment for the health condition will be instigated and managed. This should reverse the drooping of the upper eyelid.
If the ptosis is causing a functional impairment to vision, by blocking your ability to see, you will likely require treatment in the form of surgery. Most cases of ptosis can be treated by a local anaesthetic operation to tighten or advance the levator muscle in the upper eyelid. When both eyelids are affected, your surgeon will also likely recommend some sedation for your surgery. Surgery will lift the eyelid in to a more desirable position and give both improved vision and an improved cosmetic appearance.
Children born with a ptosis will need to be assessed by a paediatric ophthalmologist. A congenital ptosis can affect visual development and function and treatment needs to be initiated early to ensure that vision develops normally. Failure to assess congenital ptosis appropriately can result in amblyopia (a persistent lazy or weak eye). Children with a moderate or severe ptosis may require surgical treatment to ensure vision develops properly.