Identifying and Correcting Ptosis (Droopy Eyelids)
- Posted on: Feb 15 2018
Ptosis (“toe”-sis) is the medical term for a drooping eyelid. It refers only to the upper eyelid position (not the skin on the eyelid), and, if severe enough, ptosis can affect the upper field of vision. Ptosis does not cause blurry vision or difficulty reading an eye chart — but it definitely makes people look tired, unbalanced, or worn out. Dr. Chandler is an expert in diagnosing and, if necessary, surgically repairing the eyelid(s) to counter the drooping of ptosis.
The causes of Eyelid Ptosis
By far the most common cause of ptosis is a weak eyelid muscle due to aging. The vast majority of the Ptosis cases that Dr. Chandler sees are as a result of aging or stretching out of the upper eyelid muscles (from trauma, long term contact lens wear, prior eyelid surgery, history of a severe black eye, and many other possibilities). But the cause of a drooping eyelid isn’t always obvious. This is because the position of the upper eyelid involves the muscles, nerves, and the skin of the eyelid along with the position of the eyebrows. How alert, awake or impaired you are also can affect the openness of the eyelids as well. We all know that eyelids droop when we are really tired, drunk or under the effects of drugs (like anesthesia or marijuana). The muscles that primarily opens the eyes are called levator muscles (think elevator); they allow the eyelids to move up. They can weaken with age or due to injury. Congenitally, some people are born with weaker-than-normal eyelid muscles giving them ptosis as young children.
Nerve damage can also lead to ptosis. One common cause of nerve damage in the face and eye area is called Horner’s syndrome. Stroke and other brain injuries, spinal cord damage, and lung cancer can lead to Horner’s syndrome and also affect the size of the pupil. Other causes of Ptosis include other neurologic conditions such as myasthenia gravis. Myasthenia gravis is an autoimmune disease that affects the way the muscles and the nerves communicate. If any of these rare causes are suspected, Dr. Chandler will refer to an expert neurologist. Again, the most common cause of Ptosis is weakness of the eyelid muscles as we age.
Diagnosing Eyelid Ptosis
Even though the symptoms of ptosis are pretty straightforward — drooping of the upper eyelid — diagnosis requires true expertise since there are so many causes, variables and possible associated conditions. There is nothing simple about Ptosis.
Treating the condition (Ptosis repair)
Dr. Chandler’s treatment of ptosis varies depending on the cause. If injuries, tumors, nerve damage, or cancer are behind the ptosis, Dr. Chandler would refer to a neurologic or other specialist. In the case of myasthenia gravis, prescription medication may be used by a treating neurologist who would manage the condition. But the vast majority of healthy adults with Ptosis require outpatient surgery to tighten the eyelid muscle and help the eyelid to be more open.
Congenital ptosis (ptosis in childhood) often requires surgery because the levator muscles have not developed and usually do not function properly. In these cases adult type levator muscle surgery is not effective at correcting this complex congenital problem. Dr. Chandler would help direct patients and families to university medical centers in Philadelphia that treat children and congenital ptosis.
Ptosis will not correct itself. Most cases of ptosis are mild and will not qualify as a medical condition that is covered by health insurance. Only severe cases typically in elderly patients are considered a medical necessity needing correction. But commonly people strongly dislike when one eyelid is not symmetric with the other due to drooping, and so Dr. Chandler frequently performs cosmetic Ptosis repair to achieve symmetry between the eyelids. Few surgeons specialize in Ptosis repair and experts like Dr. Chandler spend years of training to learn how to surgically repair this challenging condition.
If you think you may have ptosis of the eyelids, please call Dr. Chandler, a top expert in Eyelid Lifting Surgery, at (609) 877-2800 or (215) 885-6830 to arrange a consultation in Philadelphia PA or South Jersey NJ.