What is Ptosis?
Ptozis (ptosis) is a condition characterized by the sagging and drooping of the upper eyelid. This condition, also known as “blepharoptosis” in medical terms, has various forms. For instance, drooping of one eyelid is called “unilateral ptosis,” while drooping of both eyelids is referred to as “bilateral ptosis.” If there is excess skin and puffiness in the upper part of the upper eyelid, this condition is called dermatochalasis.
Ptosis can be congenital (present at birth) or acquired (developing later in life). It may be temporary or permanent. The most common treatment for ptosis is surgery, typically performed on the levator muscle (the Müller muscle or levator/aponeurosis).
Ptosis can:
- Affect one or both eyes.
- Be hereditary.
- Appear at birth.
- Develop later in life.
Ptosis in Children:
Congenital ptosis refers to the condition present at birth. If a child is born with moderate to severe ptosis, they may require immediate treatment for visual development. Congenital ptosis typically occurs due to a defect in the development of the levator muscle. While often a separate issue, congenital ptosis may be associated with the following disorders:
- Eye movement disorders
- Muscle diseases
- Eyelid tumors or other tumors
- Neurological disorders
- Refractive errors
Congenital ptosis usually does not improve over time.
Symptoms and Signs of Ptosis:
The most common visible sign of ptosis in children is drooping of the eyelid. In congenital ptosis, there is often asymmetry in the upper eyelid fold. Children with ptosis may tilt their heads back or raise their eyebrows to see better. These head and facial maneuvers show that the child is trying to use both eyes for vision. Over time, these abnormal head positions can lead to neck and head posture problems.
Problems Caused by Ptosis in Children:
The most common serious issue related to childhood ptosis is amblyopia (lazy eye). Ptosis can cause amblyopia for two reasons:
- Blockage of the visual pathway in severe ptosis.
- Astigmatism and blurred vision caused by ptosis.
Additionally, ptosis may hide strabismus (misalignment of the eyes), which can also lead to amblyopia.
How is Congenital Ptosis Treated?
In most cases, pediatric ptosis is treated with surgery. If amblyopia is present, treatment may involve covering the healthy eye, using glasses, or applying eye drops. The need for surgery and the choice of method depend on factors such as:
- The child’s age
- Involvement of one or both eyelids
- Severity of ptosis
- Strength of the levator and eyelid muscles
- Eye movement status
Causes of Ptosis in Adults:
The most common cause of ptosis in adults is stretching or detachment of the levator tendon from the eyelid. This process can be caused by:
- Aging
- Cataract surgery or other eye surgeries
- Eye trauma
Adult ptosis may also be a complication of other conditions such as neurological or muscular diseases, and in rare cases, eyelid tumors that affect the levator muscle or its nerve.
How is Ptosis in Adults Treated?
An ophthalmologist can perform a thorough examination of your problem and provide information on various treatment methods and their potential risks. To diagnose the cause of ptosis and determine the best treatment, blood tests, imaging, or other examinations may be necessary. If an underlying condition is found, it should be addressed first. However, in most cases, the final treatment is surgery, and the type of surgery is determined based on the severity of ptosis and other clinical findings.
When ptosis affects only one eye, it is called “unilateral ptosis,” and when it affects both eyes, it is referred to as “bilateral ptosis.” Ptosis can be temporary or permanent. Sometimes, this condition is present from birth (congenital ptosis), and in some cases, it develops later in life (acquired ptosis).
(Wishing you a speedy recovery)
Farvardin Specialized Surgery Center