Droopy Eyelids (Ptosis): causes and treatment options

Ptosis, commonly known as droopy eyelids, refers to a condition where the upper eyelid droops lower than usual.

This drooping can obstruct vision and lead to compensatory actions such as tilting the head, which can cause headaches, neck discomfort, and additional strain. Ptosis can be unilateral (affecting one eyelid) or bilateral (affecting both eyelids).

What causes Ptosis?

1. Congenital Ptosis

• Description: Present from birth due to underdeveloped levator muscles that lift the eyelid.
• Cause: Often hereditary, affecting the muscle's ability to elevate the eyelid.
• Impact: Can lead to vision problems like amblyopia (lazy eye) if untreated.
• Treatment: Generally addressed in childhood to ensure optimal vision development.

2. Acquired Ptosis

• Description: Develops later in life due to various factors.
• Categories:
  • • Aponeurotic: The levator muscle stretches and loses elasticity, commonly due to ageing or excessive eye rubbing.
    • Neurogenic: Resulting from nerve issues that control eyelid movement, such as third nerve palsy or Horner syndrome.
    • Myogenic: Caused by weakening of the levator muscle due to conditions like muscular dystrophy.
    • Mechanical: Caused by physical abnormalities such as extra skin pulling the eyelid down.
    • Traumatic: Resulting from injury affecting the levator muscle's function.

What are the symptoms of Ptosis?

• Primary symptoms: Drooping eyelid(s), which may lead to:
  • • Squinting or double vision
    • Headaches and migraines from strained forehead and eyebrow muscles
    • Neck and back pain from adjusting head position to improve vision
    • Dry eyes and excessive watering due to improper eyelid function

Risk factors for Ptosis

• Age: Older individuals are more prone to ptosis.
• Contact lens use: Frequent eye rubbing can contribute to aponeurotic ptosis.
• Eye surgery: Previous surgeries can increase the risk.
• Anti-wrinkle injections: Poorly administered anti wrinkle treatments may migrate and cause eyelid droop.

Treatment options for Ptosis

Non-surgical treatments:

• Ptosis props: Attachments for glasses that help hold the eyelid up.
• Anti-wrinkle injections: Temporary solution to lift the eyelid.
• Scleral contact lenses: Lenses designed to support the eyelid.

Surgical treatments:

• Surgery: The most effective method to correct ptosis, involving procedures to restore the eyelid's position. Surgical options generally provide better aesthetic and functional outcomes compared to non-surgical treatments.

To understand more about your options, please visit specific procedure pages.

Meet your surgeon: Ms Susan Sarangapani

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