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What is ptosis? | Ptosis in children | Ptosis in adults

What is ptosis?

Ptosis is a medical term for drooping eyelids. It is found in both children and adults and may affect one or both eyes. The lid may droop only slightly or cover the entire eye to the point it restricts or blocks vision. Ptosis can be inherited, and it can either be present at birth or occur later in life. It is usually treated with surgery.

If the drooping eyelid is present at birth, it is called congenital ptosis. This condition occurs because the levator muscle that opens the eye doesn’t develop properly and cannot raise the eyelid. If a drooping lid blocks a child’s sight, amblyopia can occur. Amblyopia is poor vision in an eye that didn’t develop normal sight during childhood. Eyes must be used during infancy and early childhood for the visual centers in the brain to develop. If the eyes aren’t used, normal sight will not develop.

Ptosis in children

Ptosis in children doesn’t improve with time. Although it occurs rarely, children born with ptosis may also have abnormalities of their eye movements, muscular diseases, lid tumors, neurological disorders, and refractive errors.

Symptoms

The drooping eyelid is the most obvious sign of ptosis in children. Children may tip their heads back to see under the lid, or they may raise their eyebrows in an attempt to see. Over a period of time, abnormal head positions can cause deformities in the head and neck.

Treatment

Surgery is the usual treatment for ptosis in children. Before determining whether surgery is necessary and what kind of surgery is needed, the ophthalmologist must consider the child’s age, whether one or both eyelids are involved, the measurement of their eyelid height, the muscle strength of the eyelid, and the child’s eye movements. Mild or moderate ptosis may not require surgery early in life. During the surgical procedure, the ophthalmologist tightens the muscle that lifts the eyelid. If the muscle is too weak, the lid can be attached under the eyebrow so the forehead muscles do the lifting. Even if they have had surgery, children should be examined annually for amblyopia, refractive disorders, and other associated conditions because focusing problems can develop as the eyes grow and change shape.

Ptosis in adults

Ptosis in adults is caused by the separation of the elevator muscle tendon from the eyelid. It can occur because of aging, a stroke, cataract or other eye surgery, injury, or restriction of the levator muscle due to an eye tumor. Ptosis may also occur if other eye diseases such as diabetes affect the levator muscle or its nerve supply.

Treatment

Usually surgery is done to correct ptosis in adults. The surgeon takes a small tuck in the lifting muscle and eyelid to raise the eyelid. Severe ptosis may require reattachment and strengthening of the levator muscle.

Risks of surgery

Infrequently ptosis surgery can cause infection, bleeding, or reduced vision. The patient may have difficulty closing his or her eyes right after surgery, but this is a temporary situation. Eye drops and ointments can be used during this period to keep the eye moist. Although the patient may achieve an improvement in eyelid height, the eyelids may not appear to be perfectly symmetrical. A very rare complication of surgery is total lack of eyelid movement.

If you or your child are experiencing some of the symptoms described here, it does not necessarily mean you have ptosis. However, if you experience one or more of these symptoms, you should contact your eye doctor for a complete exam. Click here for information on emergency or immediate care.