Ptosis (droopy eye)

Index: 

  1. What is ptosis?
  2. What are the different types of ptosis?
  3. What are the symptoms of ptosis?
  4. What are the causes of ptosis?
  5. Can ptosis be prevented? If so, how?
  6. How is ptosis treated?
  7. What is the success rate of ptosis surgery?
  8. What will happen after surgery for ptosis?
  9. Can ptosis affect my vision?
  10. Which specialist treats ptosis?
  11. Why does ptosis tend to be so common in the elderly?
  12. If I have ptosis, what should I avoid doing?
  13. What activities will be affected the most by ptosis?

What is ptosis?

Ptosis is a drooping of the upper eyelid. It usually occurs due to a problem in the muscle responsible for raising the eyelid (the levator muscle). The problem may be degenerative or congenital in nature.

What are the different types of ptosis?

There are many different types of ptosis. The main ones include the following: 

  1. Aponeurotic ptosis – this is the most common variant and occurs because the tissue of the eyelid ages naturally. Over time, the levator muscle stretches, becoming looser, causing the eyelid to droop.
  2. Neurogenic ptosis – characterised by the lack of nervous stimulation in the muscle. It usually occurs in children and is also called Marcus Gunn Syndrome.
  3. Mechanical ptosis – occurs when there is a cyst or tumour in the upper eyelid.
  4. Myogenic ptosis – the levator muscle does not perform well and prevents the eyelid from being in the optimal position.

What are the symptoms of ptosis?

Symptoms of ptosis include:

  • drooping of one or both upper eyelids, partially or totally covering the eye
  • reduction of visual field and interference in vision, in severe cases
  • the need to tilt the head back or even lift the eyelid with your finger to see

What are the causes of ptosis?

The drooping of the eyelid typically takes place due to a weakness of the levator palpebrae muscle, damage to the nerves that control the eyelid, or to the fact that the skin loosens in the upper eyelids. Ptosis can be congenital (the patient is born with it) or acquired. Acquired ptosis may be due to normal ageing, illness, or injury.

The five most common conditions that can cause ptosis include:

  1. A tumour around the eye
  2. Diabetes
  3. Horner's syndrome
  4. Myasthenia gravis
  5. Eyelid inflammation (stye)

Can ptosis be prevented? If so, how?

Ptosis cannot be prevented, but it can be diagnosed in the initial phases, which allows for prompt and effective treatment in order to avoid vision problems. 

How is ptosis treated?

Ptosis is usually treated surgically by a process called blepharoplasty. The aim of the surgery is to repair or tighten the muscle that lifts the eyelid. However, in some cases, ptosis may not be severe enough to need treatment, while in cases caused by an underlying condition, successfully treating that condition may also resolve the ptosis.

What is the success rate of ptosis surgery?

Roughly between 80 and 85 per cent of patients who undergo surgery to correct ptosis are satisfied that their droopy eyelid has been corrected. 

What will happen after surgery for ptosis?

Once a surgical correction of ptosis has been performed, the patient will be given an eye pad to help avoid potential swelling. The patient can remove the pad themselves after 24 hours following their surgery. 

Can ptosis affect my vision?

Yes, ptosis can certainly affect the vision. If one's eyelid drops to the extent where it covers a section of one's pupil, the peripheral vision of the individual can be adversely affected. 

Which specialist treats ptosis?

Patients suffering from ptosis should see an ophthalmologist, as they are the experts when it comes to treating the eyelid-affecting condition. 

Why does ptosis tend to be so common in the elderly?

Ptosis is so common in old age simply due to the fact that, as we age, the skin on the eyelid typically tends to stretch as a result of ageing, as this area of skin is particularly thin. 

If I have ptosis, what should I avoid doing?

It is strongly advised that patients with ptosis do not drive until they have undergone effective treatment. 

What activities will be affected the most by ptosis?

Patients with ptosis will notice that reading becomes quite difficult. Also, one's ability to drive will be affected if they suffer from a droopy upper eyelid. 

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