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Drooping eyelids can affect both children and adults, and can be bothersome for a variety of reasons. This condition can also create risks for some. Dr. Sean Paul can assess the eyes to determine if ptosis is present, and what can be done to improve it. 

Drooping eyelids: What is blepharoptosis, or ptosis?

Blepharoptosis, or ptosis, is a drooping of the upper eyelid that can either be in one or both eyes. This condition can affect both adults and children, all races, and men and women equally. It can be caused by an injury, birth defect, or neurological disorder. Blepharoptosis causes the upper eyelid to fall into a position that is lower than normal, to the extent it partially covers the pupil. Ptosis may be present at birth, or may be acquired later in life. 

How is eyelid ptosis treated?

Surgical repair helps improve vision and provides a more vibrant appearance overall. There are various surgical approaches to address ptosis, including an external approach, an internal approach, and even the use of suspension slings in very severe cases. Ptosis surgery is very delicate, and requires a thorough understanding of the anatomy and function of the muscle. A thorough discussion and consultation with Dr. Sean Paul will provide answers to any questions you may have related to the procedure.

Before & After

Problems arising from ptosis

There problems that can result from ptosis are different for adults and children. In children, problems can include amblyopia (lazy eye), astigmatism (blurry vision), and crossed eyes if left untreated. In adults, the muscles that hold up our eyelids weaken and loosen as we age, and can cause our eyelids to droop. This results in a tired, sleepy appearance, and may also reduce peripheral vision. Some individuals experience brow or forehead aches and fatigue at the end of the day from constantly raising their brows to see. 

Ptosis treatment and surgery

Dr. Paul will determine the cause of your ptosis, and will then be able to plan the best treatment. If treatment is necessary, it is usually surgical. Sometimes a small tuck in the lifting muscle and removal of excess eyelid skin (called blepharoplasty) can raise the lid sufficiently. More severe ptosis—when the levator muscle is extremely weak—requires re-attachment and strengthening of the levator muscle. The lid can be attached or suspended from under the eyebrow so that the forehead muscles can do the lifting.

Childhood ptosis treatment

In many cases of childhood ptosis, the problem is isolated and does not affect the child’s vision. In other cases, surgery may be needed. If lazy eye (amblyopia) is present, treatment with patching, eyeglasses, or eye drops may be necessary. In determining which procedure is the most appropriate, these important factors will be considered: 

  • The child’s age
  • Whether one or both eyelids are affected
  • The eyelid height
  • The eyelid’s muscle strength when lifting and closing
  • Movements of the eye

Mild or moderate ptosis usually does not require surgery early in life. Children with ptosis, whether they have had surgery or not, should be examined regularly by an ophthalmologist for lazy eye, refractive disorders, and associated conditions. Even after surgery, problems with focusing can develop as the eyes grow and change shape. Any ptosis that develops over a period of days or weeks can signal a serious medical problem, and will require further neurologic and physical evaluation.

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Risks of ptosis surgery

The risks of ptosis surgery include infection, bleeding, and reduced vision, but these complications are not common. Immediately after surgery, patients may find it difficult to completely close their eye, but this is only temporary. Lubricating eye drops and ointment can be helpful during this period.

What to expect

Although improvement of the eyelid height is usually achieved, the eyelids may not appear perfectly symmetrical. In rare cases, full eyelid movement does not return, and in some cases, more than one operation may be required. Dr. Paul will be happy to discuss any of your questions and concerns about surgery outcome during your consultation.

Who is a good candidate for ptosis surgery?

Good candidates for ptosis surgery are generally healthy non-smokers who do not have a history of significant eye problems or excessive scarring or keloid formation.

Schedule a consultation with us

If you have additional questions regarding eyelid ptosis and treatment, please schedule a consultation with Dr. Paul. He will carefully examine the eyelids, taking detailed measurements of their height and the strength of the eyelid muscles, to determine the condition of the eyes so that treatment can be planned. Please call 512-559-3544 or contact us online.

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