Ptosis - Droopy Upper Lid

WHAT IS PTOSIS?

Ptosis is the term for drooping of the upper lid due to weakness of the muscle that lifts the lid (Levator muscle).

WHAT ARE THE CAUSES OF PTOSIS?

The most common cause of ptosis is due to an age-related stretching / weakening of the muscle that lifts the upper lid. It can also occur from neurologic or mechanical causes. Ptosis can also occur following routine cataract surgery and is more common in contact lens wearers. One can also be born with ptosis (congenital ptosis)

WHAT ARE THE FEATURES OF PTOSIS?

Drooping of one or both eyelids is usually noticeable and difficulty in vision, especially when reading is a common complaint. Upper field of vision is also restricted because of the droopy lid. Headaches and eyestrain may result from the excessive action of the brow muscle as this may be used as a compensatory mechanism to try to lift the eyelid.

HOW IS PTOSIS TREATED?

Neurologic and neuromuscular cases may improve spontaneously or respond to treatment of 2 the underlying cause. The most common treatment for ptosis is surgical. The goal is to tighten the levator muscle so that the lid is elevated to an appropriate height.

In adults the surgery is generally carried under local anesthesia. Most patients can go home the same day. Children and young adults may require a general anesthesia.

RISK AND COMPLICATIONS

Some bruising and swelling can be expected and settles within 10-14 days. Infection and reduced vision are rare complications. There may also be a temporary inability to fully close the eye after ptosis surgery. Lubricant drops and ointments are frequently prescribed after surgery. Although improvement of the lid height is usually achieved, perfect symmetry in the height and contour of the two eyelids is not achievable, nor the aim of surgery. More than one operation may be required in up to 10% of the patients.