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.

Adult Ptosis

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

Treatment

Adult ptosis is treated with Blepharoplasty (eyelid plastic surgery) an outpatient procedure performed using local anesthesia. When ptosis is severe enough to cause a significant reduction in vision the procedure is frequently covered by insurance.

Congenital Ptosis

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.

Ectropion

Ectropian is the 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

Entropian is the 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.