What is Ptosis?

The term ptosis refers to a dropping of the upper eyelid, such that the opening of the eye is narrow. The most common cause in adults is an aponeurosis ptosis whereby the levator muscle attachment to the eyelid wears out. This can occur in an ageing eyelid or in a younger person who has worn contact lenses for many years. Other causes of ptosis include lumps and bumps weighing down the upper lid, eyelid tumours and trauma. Rare neuromuscular diseases, such as myasthenia gravis, can also result in ptotic eyelids.

Symptoms of Ptosis

Symptoms of ptosis vary widely depending on the extent of the lid drop. Often people will be aware that they cannot see very well in the upper part of their vision. In severe cases people struggle to see straight ahead without tilting their head back. Even mild ptosis can make an eye look “sleepy” which may be socially embarrassing and represent a cosmetic issue.

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Management

All cases of ptosis, even if asymptomatic, require a thorough assessment to establish a cause. 

The mainstay of ptosis treatment is surgery which generally involves tightening the levator muscle to elevate the lid. Any loose eyelid skin or bulging orbital fat can usually be removed at the same time. 

The success rate of elevating a ptotic eyelid is generally high but there can often be a slight difference in height and contour (shape) between the two upper eyelids. Occasionally more than one operation is required to achieve a satisfactory result.

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