Droopy eyelids may be caused by a condition called ptosis. The word comes from the Greek “Blepharoptosis”, which means to fall (eyelids).
Ptosis is defined as the drooping of the upper eyelid. Ptosis can be mild and be simply a cosmetic nuisance or can be severe causing disturbance of vision by blocking the visual axis. It can cause astigmatism, if the eyelid presses on the eyeball changing the corneal curvature. Often thehe condition is caused by the levator aponeurosis stretching out over time. This lifting muscle cannot properly raise the eyelids. Ptosis is common in the elderly, because the soft tissues stretch out and lose elasticity over time. It may be seen to worsen at the end of the day when the patient becomes tired.
It is also possible to be born with ptosis (congenital ptosis) where the levator aponeurosis is not formed normally in utero. If the eyelid blocks vision, it is best to treat the condition early in order to decrease the risk of amblyopia. Amblyopia is when the visual pathways in the brain are not normally developed causing blurred vision in the affected eye. Ptosis may also be caused by trauma, various neurologic issues and other more rare causes.
Treatment for ptosis can be performed as an outpatient with IV sedation for most patients. Young children need deeper sedation for ptosis repair.
Blepharoplasty Upper Eyelids with Ptosis Repair
There are several ways to repair ptosis. Levator advancement is a procedure used to tuck the lifting muscle and is performed through an eyelid crease incision. A mullerectomy is a popular technique to tighten the eyelid lifting structures through an internal approach not requiring an external incision. A Fasanella-Servat is another internal lifting technique which does not require a skin incision.
Blepharoplasty Upper with Ptosis
For congenital ptosis with fair function, a levator resection may be recommended which lifts and removes part of the underperforming levator aponeurosis. Another method for repairing ptosis from congenital or neurologic causes may be to use a Frontalis sling. This involves using implanted material to allow forehead muscles to help with lifting the eyelids. A non-surgical method, is prescribing “crutch” glasses, which support the eyelid using special attachments. If the ptosis is a symptom of a disease, then diagnosing and treating the underlying condition is paramount.
In thinking about repairing ptosis, it is recommended to consult with an Oculoplastic surgeon who is experienced with these types of surgeries. He or she will determine if you are a good candidate.