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Ptosis
Understanding About Ptosis
Ptosis, also known as droopy eyelid, is a condition where the upper eyelid falls to a lower position than normal. It can affect one or both eyes and may partially or fully block vision. Ptosis can occur at any age but is most common in older adults due to the weakening of muscles that control the eyelids. Other causes include congenital issues, nerve damage, or trauma.
Types of Ptosis:
Present at birth, this occurs when the muscles that lift the eyelid (levator muscles) don’t develop properly. It may affect one or both eyes.
Develops later in life and has several subtypes:
- Involutional Ptosis: The most common type, caused by aging and the natural weakening of eyelid muscles.
- Neurogenic Ptosis: Results from nerve damage or conditions like Horner’s syndrome or third cranial nerve palsy.
- Myogenic Ptosis: Caused by muscle diseases like myasthenia gravis, which weaken the muscles.
- Traumatic Ptosis: Caused by injury or trauma to the eyelid or surrounding areas.
- Mechanical Ptosis: Results from the weight of a mass, tumor, or excess skin pulling the eyelid downward.
Symptoms:
The most obvious symptom is a drooping upper eyelid, which may block vision partially or entirely.
Patients may struggle to keep their eyes open or may need to raise their eyebrows to compensate.
The effort to lift the drooping eyelid can cause fatigue, particularly after long periods of reading or focusing on tasks.
In cases where only one eye is affected, the face may look uneven.
In some cases, ptosis can cause or contribute to double vision, especially if other muscles or nerves are involved.
Treatment:
In mild cases, especially in children, doctors may simply monitor the condition to see if it worsens over time.
Specially designed glasses can have small crutches that help lift the eyelid, offering a non-surgical solution.
If ptosis is caused by an underlying condition like myasthenia gravis, medications may help manage the symptoms.
For moderate to severe ptosis, surgery (blepharoplasty or ptosis repair) may be needed to tighten the levator muscle or, in extreme cases, to attach the eyelid to the brow muscles for better lift.
Precautions:
Use sunglasses to protect sensitive eyes from bright light and UV exposure.
If ptosis affects vision, especially in children, regular check-ups are needed to avoid complications like lazy eye (amblyopia).
If ptosis is related to an underlying disease (e.g., myasthenia gravis or diabetes), controlling the primary condition can help slow its progression.
Rest your eyes during prolonged tasks like reading to avoid fatigue.
Before Surgery
Before ptosis surgery, a detailed eye examination will be performed to assess the severity of the droop and its effect on vision. The surgeon will explain different surgical options based on the cause and severity of the ptosis. You may need to stop taking certain medications, such as blood thinners, a few days before surgery to reduce the risk of bleeding. Surgery is typically done under local anesthesia, and the goal is to tighten the levator muscle or use the brow muscles to help lift the eyelid.
During Surgery
Ptosis surgery is generally performed under local anesthesia, meaning you’ll be awake but pain-free. The surgeon makes a small incision, usually in the natural crease of the eyelid, to access and tighten the levator muscle. If the levator muscle is too weak, the surgeon may attach the eyelid to the brow muscles to aid in lifting. The procedure usually takes 45 minutes to 1 hour. Afterward, your eye will be covered with a protective dressing.
After Surgery
After surgery, your eye may be swollen or bruised, but this will improve in a few days. You’ll need to use prescribed antibiotic and anti-inflammatory eye drops to prevent infection and manage swelling. Avoid strenuous activities, swimming, or rubbing your eyes during the recovery period, which typically lasts 2 to 3 weeks. Keep follow-up appointments to ensure proper healing. Most patients experience significant improvement in both vision and appearance, although slight asymmetry may persist in some cases.
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