Ptosis (pronounced “toe-sis”) is the medical term for droopy eyelids (drooping of the upper eyelid) and can also refer to drooping of the brows. This lowering of the upper eyelid margin may cause a reduction in the field of vision when the eyelid either partially or completely obstructs the pupil. Patients with ptosis often have difficulty keeping their eyelids open. To compensate, they will often arch their eyebrows in an effort to raise the drooping eyelids. In severe cases, people with ptosis may need to lift their eyelids with their fingers in order to see. Children with ptosis may develop amblyopia (“lazy eye”) or developmental delay from limitation of their vision.
What Causes Ptosis?
There are many causes of ptosis including age related weakening of the muscle, congenital weakness, trauma, or sometimes neurologic disease. As we age, the tendon that attaches the levator muscle, the major muscle that lifts the eyelid can stretch and cause the eyelid to fall. This represents the most common cause of a droopy eyelid. Ptosis may also occur following routine lasik or cataract surgery due to stretching of the muscle or tendon. Brows also descend with age. Children may be born with ptosis or may acquire it due to trauma or neurologic reasons.
Can Ptosis be Corrected?
Ptosis can be corrected surgically and usually involves tightening the levator muscle to elevate the eyelid. In severe ptosis, when the levator muscle is extremely weak, a “sling” operation may be performed, enabling the forehead muscles to elevate the eyelid(s). Other types of repair may include surgery on the muscle on the inside of the lid in cases of small amounts of ptosis. The surgeon will perform testing to determine the best form of correction for the individual patient. The goal is to elevate the eyelid to permit a full field of vision and to achieve symmetry with the opposite upper eyelid.
Who Should Perform Ptosis Correction?
Ptosis surgery should be performed by a cosmetic and reconstructive facial surgeon who specializes in the eyelids, orbit, and tear drain system. Dr. Harris and Dr. Call belong to the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), which indicates they not only are board certified ophthalmologists who know the anatomy and structure of the eyelids and orbit, but also have had extensive training in ophthalmic plastic reconstructive and cosmetic surgery.
Droopy eyelids before and 1 week after surgery
Child before and after repair of congenital ptosis