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Ptosis - Drooping of the eyelid

Ptosis refers to drooping of an upper eyelid of one or both eyes. The droop may be barely noticeable, or it may cover the pupil entirely. Ptosis can affect both children and adults, but usually occurs because of aging.

Features of Ptosis

  • Affect one or both eyelids
  • Be inherited
  • Be present at birth
  • Occur later in life
If a child is born with ptosis, it is called “congenital ptosis.” Congenital ptosis is often caused by poor development of the muscle that lifts the eyelid, called the levator muscle. This condition usually doesn’t improve on its own over time. With moderate to severe congenital ptosis, the child may need treatment to have his or her vision develop normally.

What problems can result from ptosis in children?

The most serious problem associated with childhood ptosis is amblyopia (lazy eye), which is poor vision in an eye that did not develop normal sight during early childhood. This can occur if the lid is drooping severely enough to block the child’s vision. More frequently, amblyopia can develop because ptosis tends to lead to constant blurriness of visual images, causing astigmatism. Ptosis can also hide misaligned or crossed eyes, which can cause amblyopia.

Signs of Ptosis

The most obvious sign of ptosis is the drooping eyelid. Depending on how severely the lid droops, people with ptosis may have difficulty seeing. Sometimes people tilt their heads back to try to see under the lid or raise their eyebrows repeatedly to try to lift the eyelids.

Treatment of Ptosis

Surgery usually is the best treatment for drooping eyelids. In the case of children this surgery becomes an urgent procedure. In an adult it can be done based on the convenience of the individual. There are two different types of surgery that can be done. Each surgery has its advantages and your doctor will explain to you which type of surgery is best for you and why.

Frequently Asked Questions

Ptosis is the medical term for a drooping or droopy upper eyelid. It comes from the Greek word ptosis, meaning “to fall.”

Yes.If a child’s ptosis, or droopy or drooping upper eyelid, is severe enough, then it can interfere with the normal development of vision and lead to amblyopia, which is the leading cause of vision loss among children and young adults.

Yes. Ptosis can lead to other vision problems, including astigmatism, or an irregularly shaped cornea, or amblyopia, also commonly called lazy eye. It is important when you take a child to the doctor for a routine well-child visit that the doctor screen or test his or her vision to detect vision abnormalities such as ptosis or vision abnormalities that develop as a result of ptosis.

Yes. If ptosis is detected through a vision screening, then children should visit a pediatric ophthalmologist for a full evaluation so that appropriate treatment can begin. If the ptosis is causing astigmatism or amblyopia, then your ophthalmologist may prescribe glasses or have the child wear a patch to strengthen their weak eye. Surgery may be required if a droopy eyelid is blocking a child’s vision. A child’s eyelid can be elevated through various methods, such as contraction of the frontalis muscle in the forehead.

Ptosis can be caused, among other things, by various neurological conditions that affect the nerves or muscles of the eye, including Horner syndrome or third nerve paralysis, or by an eyelid mass.

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