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What Is Ptosis and How Is It Diagnosed and Treated?

Mar 02, 2023

Oculofacial Plastic Surgery

What Is Ptosis and How Is It Diagnosed and Treated? What Is Ptosis and How Is It Diagnosed and Treated?

Ptosis is an eyelid condition that causes your upper eyelid to droop downwards, obstructing your pupil. It can affect one eye (unilateral ptosis) or both eyes (bilateral ptosis) simultaneously. It could be either congenital (present by birth) or developed later in life. While mild ptosis can go away on its own, severe cases may require medical attention. If left untreated, severe ptosis can lead to poor vision or blindness. 

Knowing the causes and symptoms of ptosis will help you identify and treat it earlier, thus avoiding complications.

Causes of Droopy Eyelids

Age: As you age, the skin and tissue around your eyes lose collagen and become weaker, causing your eyelids to droop gradually.

Eye Surgery: Surgeries such as LASIK, cataracts, or glaucoma may stretch or damage your eye muscles, resulting in saggy eyelids.

Horner Syndrome: Damage to some nerve pathways affects your eyes, causing ptosis with a smaller pupil.  

Eyelid Tumor (Mechanic Ptosis): A tumor stresses your eyelid downwards. You might have a tumor on your eyelid if you have neurofibromatosis type 1 (a genetic disorder). 

Eye Injury: A trauma or accident damaging the eye muscle can cause drooping. Often rubbing your eyes or wearing contact lenses for several years may also cause ptosis.

Myasthenia Gravis (Autoimmune Condition): Your immune system attacks and weakens the signal between your eyelids’ muscles and nerves, resulting in ptosis.

Eye Infection: A stye (sty) or conjunctivitis (pinkeye) can swell your eyes, causing a bump on your eyelids. However, it will subside within a few weeks.

Brain Aneurysm: Damaged or weakened blood vessels in the brain can burst, causing a hemorrhage with symptoms such as vision changes, droopy eyelids, numbness, etc.

Diabetes: Uncontrolled diabetes can damage nerves and blood vessels in and around your eyes, causing drooping with double vision.

Stroke: It occurs when your brain’s blood flow is reduced or blocked (by a clot), causing one side of your face to droop, including your eyelids.

Muscle Problems: Oculopharyngeal muscular dystrophy affects your throat and eye muscles, causing throat problems and droopy eyelids with poor vision. 

Mitochondrial Myopathies: Genetic diseases can impact the function of mitochondria (which powers most body cells), thus causing your eyes and eyelids to droop.

Serious Headaches: Headaches such as migraines or problems with the trigeminal nerve (running through your face and jaw) can trigger Horner syndrome, causing ptosis.

Botox (Botulinum Toxin): The toxin might damage or weaken your eye muscle controlling the upper eyelid and cause drooping. 

Symptoms of Droopy Eyelids

  • Eye fatigue or aches
  • Trouble blinking or closing the eye
  • Difficulty seeing
  • Dry or watery eyes

Children with ptosis may experience additional symptoms, including:

  • Eye strain
  • Headaches 
  • Dizziness 
  • Astigmatism, farsightedness, or nearsightedness 
  • Blurred, distorted, or double vision 
  • Amblyopia (lazy eye – one eye seems abnormal, looking in another direction)

Ptosis Diagnosis

Your doctor will review your medical history and perform a physical exam to test your eyelids, including measuring your eyelids’ height and eyelid muscles’ strength. Also, they may ask you how long you have been experiencing droopy eyelids and other symptoms if any. 

They will also perform the following procedures to diagnose ptosis:

Slit Lamp Exam: Examines all the areas of your eye (lens, iris, retina, eyelids, etc.) with a high-intensity light.

Visual Field Test: Checks whether your vision is normal while you look at various flashlights without moving your eyes.

Tensilon Test: Your doctor will inject Tensilon drug into your vein and ask you to sit/stand or cross and uncross your legs several times to see whether the drug increases your muscle strength. If it does, your droopy eyelid could be caused by myasthenia gravis (which weakens eye muscles). 

Ptosis Treatment 

The treatment will vary depending on the causes and severity of your condition. You may not need medical treatment if your droopy eyelid is congenital or caused by age, as it usually won’t impact your health. However, you can choose eyelid surgery to reduce or eliminate drooping. If your ptosis is caused by an underlying medical condition, such as myasthenia gravis or a stroke, your doctor will treat the underlying condition to correct your eyelids.

Common treatment options for droopy eyelid include:

Droopy Eyelid Surgery: It tightens the levator muscle to lift the eyelid into the desired position.

Sling Operation: Uses the forehead muscles to elevate eyelids.

Ptosis Crutch: Includes adding an attachment to your eyeglasses’ frames, which keeps the eyelid in place, thus preventing drooping. 

While ptosis creates a cosmetic problem like a tired or asymmetric appearance, it can also be a sign of a life-threatening medical condition, such as stroke, brain aneurysm, etc. Seeing a doctor is recommended as soon as you develop ptosis, so the root cause is diagnosed and treated on time. 

Contact Remagin for Droopy Eyelid Treatment near You  

At Remagin, we have experienced and skilled ophthalmologists to accurately diagnose and treat ptosis with desired results. Contact us today to schedule an appointment.  

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