Eyelid ptosis (pronounced “toh-sis”) is a condition in which the upper eyelid droops or sags. It can affect one or both eyes. Sometimes the eyelid droops enough to obstruct the upper field of vision and/or side vision, requiring correction.
Ptosis Repair (upper eyelid surgery) is a surgical procedure that can correct droopy eyelid(s). Depending upon the degree and cause, ptosis repair involves either resection (shortening) of a muscle in the eyelid or suspension with a muscle of the brow. Typically, the levator muscle (the major muscle responsible for elevating the upper eyelid) is shortened though an incision made along the natural crease of the lid. Excess skin weighing down the eyelid may also be removed.
Present from birth, the most common cause of congenital ptosis is the improper development of the levator muscle. Children may need to tilt their head back or lift their eyelid with a finger to see. They may also develop amblyopia (“lazy eye”), strabismus (eyes that are not properly aligned), astigmatism, or blurred vision. Repair for mild to moderate congenital ptosis is generally performed between ages 3 and 5. Severe visual obstruction may require earlier treatment.
Congenital ptosis surgery is usually performed in an outpatient surgical facility under general anesthesia so the child will not become anxious or restless during the procedure.
Most commonly due to age-related weakening of the levator muscle, acquired ptosis may also be caused by injury, trauma, or procedures, such as cataract surgery, which can cause weak tendons to stretch. Acquired ptosis may also be the first sign of some diseases, such as myasthenia gravis (a disorder in which the muscles become weak), or Horner’s syndrome (a neurological condition that indicates injury to part of the sympathetic nervous system).
Acquired ptosis surgery is usually performed in an outpatient surgical facility under anesthesia that induces a “twilight” state. Sedated consciousness is preferred so the surgeon can accurately adjust the eyelids.