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Ptosis - Causes, Symptoms & Treatment


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Ptosis (pronounced toe' sis), or drooping of the upper eyelid , may occur for several reasons such as: disease, injury, birth defect, previous eye surgery and age. The droop may be barely noticeable, or the lid can descend over the entire pupil . The eyelids serve to protect and lubricate the outer eye. The upper eyelid is lifted by a muscle called the lwevator muscle. The muscle controlling lid opening is the levator palpebrae superioris and it is innervated by the third cranial nerve. Ptosis is a drooping or sagging of a body part. Blepharoptosis is a drooping of an upper eyelid. Abnormal lowering or drooping of an organ or a part, especially a drooping of the upper eyelid caused by muscle weakness or paralysis. This is a more complex procedure in which muscles of the brow or forehead may be used to assist in elevation of the upper eyelid.

Ptosis is defined as a drooping of the upper eyelid below its normal level resulting in narrowing of the palpebral opening. It can affect one eye or both eyes and is more common in the elderly, as muscles in the eyelids may begin to deteriorate. Children born with ptosis may require surgical correction of the lid if it covers the pupil. There are two types of ptosis, acquired and congenital. Acquired ptosis is more common. Ptosis occurs when the muscle that usually raises the eyelid is not strong enough to do so. Congenital ptosis can also occur when the innervation to the levator is interrupted through neurologic or neuromuscular junction dysfunction. Ptosis can occur in both children and adults, but happens most often due to aging.

Causes of Ptosis

Common causes and risk factor's of Ptosis include the following :

  • Blepharophimosis syndrome.
  • Horner syndrome.
  • Birth trauma.
  • Diabetes.
  • Myasthenia gravis.
  • Periorbital tumor.
  • Duane syndrome.
  • Stroke.

Symptoms of Ptosis

Some common Symptoms of Ptosis :

  • Drooping lid .
  • Double vision.
  • Difficulty closing the eye completely.
  • Crossed or misaligned eye.
  • Children may tilt head backward in order to lift the lid.
  • Irritation. 
  • Eye fatigue from straining to keep eye(s) open.

Treatment of Ptosis

  • Treat underlying condition causing the ptosis
  • Surgery can generally be done on an outpatient basis under local anesthetic.