This eyelid condition obstructs vision and can be congenital (present at birth) or acquired later in life. It is generally corrected by eyelid surgery.
Congenital Ptosis
This condition is either inherited or occurs as an isolated birth defect and is already noticeable in very small babies. This is most likely due a weak levator muscle which raises the eyelid. Occasionally the vision on the affected side may be reduced. The child will need regular monitoring of his/her vision. Surgery can be carried out if the vision is not developing normally or to improve the appearance.
Acquired Ptosis
This could be due to:
- Defect of the levator muscle tendon due to ageing or contact lens wear
- Weakness in the eyelid muscles occurring in some rare muscle condition
- Problem with the nerve which controls the muscle of the eyelid
- Mechanical defect caused by lid swelling/cyst
TREATMENT
This usually involves surgery. For children this can generally be performed from the age of 3-4 years under general anaesthesia (asleep). In adults, it is preferable to carry out the operation under a local anaesthetic with the patient awake but sedated. A co-operative patient allows the surgeon to set the eyelid height and shape more accurately at the time of surgery.
If both eyes are affected, the surgery is usually carried out on both sides at the same time. The type of operation depends on the cause of the Ptosis. This usually involves shortening and strengthening the levator muscle which opens the eyelid.
Occasionally, the lid is raised by suspending it from the brow muscle. The tissue used for this may be man-made or harvested from the leg through a small cut above the knee.
Note: All treatment is preceded by a consultation and examination to establish the correct diagnosis.