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Ptosis

Definition:

Ptosis is an abnormally low position of the upper lid. Ptosis or "drooping eyelid," caused by weakness of the muscle responsible for raising the eyelid, damage to the nerves that control those muscles, or looseness of the skin of the upper eyelids. This can cause difficulty in seeing, especially with severe eyelid drooping results in double vision. It can be more visible when the person is tired or have been awake past sleeping time.

Causes:

  • Congenital (from birth).
  • The condition, which generally appears in old age but can also result from diabetes, brain tumor, stroke, or accident, can affect one or both eyelids and worsen or improve over time.

Types of Ptosis:

  • Neurogenic ptosis.
    • Caused by nerve palsy such as third nerve palsy (which supply the nerve impulses to the upper eyelid) or misdirection of the nerve.
  • Myogenic ptosis.
    • Caused by myopathy of the levator muscle (improper functioning of the eyelid elevating muscle).
  • Aponeurotic ptosis.
    • Caused by defect in the levator aponeurosis (defect in the muscle to bone connection).
  • Mechanical ptosis.
    • Caused by swelling or scarring ( any prominent swelling seen in the upper eyelid).

Symptoms:

  • Drooping of one or both eyelid.
  • If ptosis is severe, it interferes with the vision.

Treatment Options:

If an underlying disease is found, the treatment will be specific to that disease. Most cases of ptosis are associated with aging and there is no disease involved. Surgery can be done to improve the appearance of the eyelids in milder cases if the patient wants it. In more severe cases, surgery may be necessary to correct interference with vision. In children with ptosis, surgery may be necessary to prevent amblyopia (one eye having lesser vision when compared to the other eye) The amount of ptosis and levator function (the muscle which is responsible for eyelid elevation) is measured before planning for any treatment option.

  • The available treatment options are,
    • Crutch glasses (glasses which elevate the upper eyelid).
  • Surgery.
    • Fasanella.
    • Levator resection.
    • Frontalis suspension servat procedure (Aurolab manufactures Aurosling for this surgical procedure to correct ptosis).
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