Ptosis (pronounced “toe-sis”) is a condition characterized by the drooping of an upper eyelid. Only the upper eyelid is affected in one or both eyes. The degree of drooping varies considerably from person to person, from barely noticeable to covering the pupil entirely. Ptosis occurs most frequently as a result of aging, yet it can occur at any age.
Signs and Symptoms
A lower-than-normal positioning of one or both upper eyelids is the most prominent sign of ptosis. People with this condition may have trouble with vision, depending upon how low the lid droops. In response to ptosis, some people will raise their eyebrows in an effort to lift their eyelids, or tilt their heads back to view from beneath their lids.
If you feel that you may have ptosis, a good way to check is to compare a recent photo of your face with one from at least a decade ago. Check for any evident changes in the position of your upper eyelids.
Ptosis shares some symptoms with dermatochalasis, which is a connective tissue disease that’s associated with reduced elastic tissue formation. In this condition, skin hangs down in folds. Your eye doctor should be able to discern which problem is causing your drooping eyelids.
Causes of Ptosis
Sometimes ptosis is congenital and present at birth. Other cases develop due to injury, as an after-effect of eye surgery, or from aging. A problem with the levator muscles responsible for raising the eyelid can also result in ptosis. Other possible sources for drooping eyelids include neurological disease, an eye tumor or a systemic disease, such as diabetes.
Treatment for Ptosis
The optimal treatment for ptosis is generally eyelid surgery, also known as blepharoplasty. In order to restore eyelids to their proper place, the surgeon tightens the levator muscles. In extreme cases, the eyelid may be attached under the eyebrow, which allows forehead muscles to assume responsibility for lifting the eyelids.
Following the surgery, eyelids will be higher than before yet they may not appear symmetrical. On rare occasions, eyelid movement is lost or compromised.
Research and choose your blepharoplasty surgeon carefully. This is the best way to ensure a good result and appearance, and to prevent the side-effect of surgically induced dry eyes due to eyelids that don’t close properly. Inquire as to how many procedures your surgeon has already performed, and ask to see before and after pictures of previous patients. You may also want to call them for a reference.
Ptosis in Children
When ptosis is present in childhood, treatment is required for the vision system to develop properly. Failure to treat ptosis can cause amblyopia and poor quality vision in the future.
All children with ptosis, even if it’s mild, should visit their eye doctor annually to monitor eyelid positioning and inspect for any visual conditions.