Ptosis
Ptosis, commonly referred to as drooping eyelid, is a condition characterized by the drooping of one or both upper eyelids, which can partially or completely cover the eye. This can result from a variety of causes, including paralysis of motor and sensory nerve fibers, muscular dystrophy, diabetes, brain tumors, head or eyelid injuries, and myasthenia gravis. The symptoms often include poor blinking reflexes, which can lead to eye infections and increased irritation.
Ptosis can be congenital, stemming from malformations of the levator muscle or defective nerve supply, and may not improve on its own over time. Treatment options vary based on the underlying causes and may include the use of artificial teardrops, medications, or surgical intervention to tighten the levator muscle. Surgical correction is particularly common in children, as untreated ptosis can result in visual complications such as amblyopia, or lazy eye. Overall, addressing ptosis is crucial to prevent potential long-term effects on vision and facial appearance.
Ptosis
ALSO KNOWN AS: Drooping eyelid
ANATOMY OR SYSTEM AFFECTED: Eyes, muscles, nerves
DEFINITION: Drooping of the upper eyelid, partially or completely covering the eye
CAUSES: Paralysis of motor and sensory nerve fibers to eyelids, muscular dystrophy, diabetes, brain tumor, head or eyelid injuries, myasthenia gravis
SYMPTOMS: Drooping upper eyelid, poor blinking reflexes, eye infections
DURATION: Short-term to chronic
TREATMENTS: Artificial teardrops, medications for underlying disorders, surgery
Causes and Symptoms
Ptosis may be congenital or may be associated with other problems, including of motor and nerve fibers to the eyelids, muscular dystrophy, diabetes, tumor, head or eyelid injuries, myasthenia gravis, or a in the upper lobe of a lung. In young children, congenital ptosis is the result of malformation of the levator muscle, which lifts the eyelid, or of a defective nerve supply to the muscle. Congenital ptosis usually does not improve with time. Symptoms include drooping of one or both eyelids, which may vary during different times of the day, as well as associated poor blinking reflexes.
Treatment and Therapy
Home treatment involves keeping the child’s eye moist with artificial teardrops. Medical prescriptions are not necessary for ptosis, but they may be needed for underlying disorders. The typical treatment for childhood ptosis is surgery, which involves tightening the levator muscle. The surgeon must be very careful not to raise the eyelid so high that the eye cannot be closed, and also to make it match the other eyelid as closely as possible. In cases involving older children, some ophthalmologists may recommend keeping the affected eyelid raised with a support that is part of a pair of eyeglasses.
Perspective and Prospects
Complications that can arise from ptosis include permanent disfigurement of the face, visual difficulties, and irritation and infection of the eye that is caused by poor blinking reflexes and continual contact between the eyelid and the surface of the eye. If the disorder is not corrected in younger children, it can lead to amblyopia (lazy eye). Since amblyopia persists throughout life if it is not treated early in childhood, ptosis can lead to permanently poor vision. Ophthalmic plastic and reconstructive surgeons who specialize in ptosis and conditions affecting the eyelids, the tear system, the bone cavity around the eye, and adjacent facial structures have made significant progress in the successful surgical correction of ptosis.
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