Drooping of the upper eyelid is known as ptosis or blepharoptosis. The upper eyelid falls to a lower than normal position. Ptosis can affect one or both eyes. Some patients are born with ptosis, known as congenital ptosis. When it is present at birth, it usually only involves one eye. If it is not treated early, it can result in the permanent loss of vision in infants.
There are many different causes of acquired ptosis. One of the most common is aponeurotic or age related ptosis. The long-term effects of gravity, combined with aging changes of the levator muscle and tendon that raise the upper lid lead to this type of ptosis. Often, patients who have undergone cataract surgery, or who wear hard contact lenses are at an increased risk for the development of this type of ptosis.
There are also a number of medical conditions that can lead to the development of ptosis. Some of these conditions can be quite serious. Myasthenia gravis is a disorder that affects the way that your nerves impulses are transmitted to your muscles. Patients with this condition often present with a history of ptosis that often fluctuates throughout the day. Horner’s syndrome is another condition that can cause ptosis. The condition can be seen in association with tumors in the upper lobe of the lung. As well, strokes, brain tumors, and aneurysms can all be associated with ptosis by damaging the nerve fibers that control the eyelid muscles.
Since there are so many causes of ptosis, it is essential that you are seen and evaluated to determine the underlying cause of the ptosis. A thorough history and physical examination are essential to the correct diagnosis. Old photographs are also helpful in determining the chronicity of the ptosis.
The ocular symptoms caused by ptosis vary according to the severity. In milder cases, it is often a cosmetic issue. In more severe cases, it can limit your central and peripheral vision, and lead to fatigue, especially when reading.
Treatment of ptosis depends on the underlying etiology. If the ptosis is due to myasthenia, medical treatment alone will often correct the problem. For cases of age related ptosis, cosmetic eyelid surgery can correct the problem. The goal of surgery is to elevate the eyelid to its normal position, to allow normal visual development and a full field of vision. There are a number of surgical treatments for ptosis, depending on the severity of the disease, and which muscles are predominantly affected. The surgery is done under local anesthesia, on an outpatient basis.