Ptosis

Definition: Ptosis (pronounced "toe-sis") is a condition in which the upper eyelid droops to partially or completely cover the pupil, restricting or obscuring vision.

Causes: Ptosis which is present at birth (inherited) is called congential ptosis. Adult ptosis, usually caused by the separation of the levator muscle tendon from the lid, can occur as the result of aging, following cataract or other eye surgery or from an injury. It may also result as a complication of other diseases involving the levator muscle or its nerve supply, such as diabetes. An eyelid tumor may also restrict the movement of the muscle and cause ptosis. Untreated childhood ptosis will result in the continued condition as an adult.

Childhood Ptosis: Amblyopia, poor vision in an eye that failed to develop normal sight during childhood, is the most serious problem associated with childhood ptosis. A drooping eyelid may be severe enough to block vision or cause astigmatism. It can also mask a misalignment or crossing of the eyes.

Congenital ptosis does not usually improve over time. Severe ptosis may require prompt surgery to avoid amblyopia and allow the vision to develop properly. Mild or moderate ptosis requires periodic eye exams to check for refractive errors that may need correction with glasses and to continue to monitor the development. Surgery for cosmetic reasons is frequently performed before school age.

Adult Ptosis may result in impaired vision and fatigue from attempting to elevate the eyelid. An ophthamolic consultation should be sought to determine the cause and evaluate treatment options.

Additional adult eyelid disorders usually associated with aging are:

• Ectropion - outward turning of the lower eyelid
  Occurs with the stretching of the lower eyelid skin with age. Eyelid burns or skin disease may also cause this problem. Ectropian can cause dryness of the eyes, excessive tearing, redness and sensitivity to light and wind. Surgery may restore the normal position of the eyelid, improving these symptoms.
  
  
• Entropion - inward turning of the lower eyelid
  Occurs most commonly as the result of aging. Infection and scarring inside the eyelid are other causes of entropion. When the eyelid turns inward, the eyelashes and skin rub against the eye, making it red, irritate and sensitive to light and wind. If not treated, an eye ulcer may form. Surgery can turn the eyelid outward to its normal position.

Treatment: Eyelid plastic surgery is usually performed on an outpatient basis using local anesthesia. The surgical procedure for ptosis corrects the problem by shortening the muscle that opens the eyelid.

Note: The information on this website is not a substitute for professional care. If you are having any problems with your eyes, you should see your ophthalmologist or optometrist for diagnosis and treatment.

Information for this section has been reviewed and approved prior to posting by Florida Eye Institute in Vero Beach, Florida. Physician: Dr. Todd.