PTOSIS

It is a condition in which upper eyelid droops, sags or falls over your eye. 

• The most obvious symptom is a droopy eyelid, which can be subtle or severe.

• To see better, a person might tilt their head back, lift their chin, or arch their eyebrows. 

• The condition can limit your vision or block it completely, depending on how much lid droops. 

• Ptosis of the eyelid can affect one or both upper eyelids.

• It can also be worse in one eye than the other.It can be present at birth (congenital) or develop later in life (acquired).

• If the ptosis is severe in young children it can affect the development of normal vision. 

• In adults ptosis can block vision and be bothersome while reading or driving. 

• Adults and children often try to compensate for the droopy eyelid by using the forehead muscles to help lift the eyelid.

• Physical exam: A doctor will review your medical history and perform a physical examination. 

• Slit lamp exam: A high-intensity light is used for a detailed view of the eye and eyelid structure. 

• Measurement: A doctor may measure the Marginal Reflex Distance (MRD1), which is the distance between the top of the pupil and the upper eyelid's edge, to quantify the amount of droop. 

• Muscle Function test: The strength and function of the eyelid-lifting muscles are checked. 

• Neuroimaging: An MRI or CT scan may be requested to check for underlying causes like tumors or nerve damage. 

• Age-related (involutional): The levator muscle, which lifts the eyelid, stretches and separates from the eyelid over time. 

• Congenital: Issues with the levator muscle present from birth. 

• Nerve or Muscle Damage: Trauma, nerve damage, or neurological conditions can affect the muscles controlling the eyelid.

• Underlying Medical Conditions: Systemic diseases like myasthenia gravis, tumors, infections, or eye surgeries can also cause ptosis. 

Ophthalmologists consider the following factors when deciding the best way to treat ptosis

• The child’s age

• Whether one or both eyelids are involved

• The eyelid height

• The strength of the eyelid’s levator (lifting) muscle

• The eye movements

Ptosis treatment in adults depends on the severity and cause of the condition, with options including non-surgical management like

• Ptosis crutch eyeglasses

• For ptosis caused by underlying medical conditions like myasthenia gravis or neurogenic causes, treating the underlying disease is crucial.

• Surgery: The primary treatment for significant ptosis is surgery to tighten or reattach the levator muscle, improving the eyelid's height and function.

Vision Problems: In severe cases, ptosis can limit or block vision. 

Amblyopia (Lazy Eye): In children, a drooping eyelid that blocks vision can lead to poor development of the vision, known as a lazy eye.