Ptosis: symptoms, causes and treatment

Ptosis definition

Ptosis or blepharoptosis is when your upper eyelid drops. As people age, the lower eyelid often starts to sag as a result of the reduced strength of the muscles controlling the eyelid. However, if the drooping is the upper eyelid, your vision may be impaired.

Ptosis is often confused with another condition called lazy eye. However, the two are different. Lazy eye is just one of several symptoms that arise from ptosis.

Ptosis can block or reduce vision, depending on how much your eyelid covers the pupil. In general, ptosis is a condition that can get better, either naturally or through medical intervention.

How common is this condition?

Ptosis is a condition that can occur in patients of any age. Both children and adults can develop ptosis.

This condition can be treated by reducing risk factors. Talk to your doctor for more information.

Ptosis symptoms

The main symptom of ptosis is drooping of one or both eyelids. In some cases, ptosis is a condition that can affect your vision.

However, many people don't feel their eyelids droop or even that their eyelids are fine. You may also experience very dry or very watery eyes, and your face may look tired.

You can experience pain, which can make you look tired. Some patients have severe cases even needing to tilt their head when speaking.

The doctor will investigate the condition to make sure there is no underlying condition. This is especially important if you have migraine headaches or other problems that have occurred since you experienced this condition.

There may be signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

When should I see a doctor?

You should call your doctor if you experience any of the following symptoms:

• Lowering of the eyelids affects your appearance or vision
• One of the petals suddenly drops or closes
• Accompanied by other symptoms, such as double vision or pain
• Lowered eyelid in children
• New or rapid eyelid changes in adults.

Causes of ptosis

Basically, the causes of eyelid ptosis can be divided into two, namely those that occur naturally and the drooping of the eyelids caused by certain health conditions.

Causes of natural eyelid ptosis

Anyone can get ptosis. However, this condition is common in the elderly because ptosis can also be caused by age, aka the aging process.

Normally, the tendon attaches to the levator muscle which functions to lift the eyelid. As you age, that muscle can stretch and cause your eyelids to droop.

Babies can also be born with this condition, although the cases are rare. It's not known what causes congenital ptosis. However, the main cause is an underdeveloped levator muscle, which affects the ability to open the eyes.

Children who have this condition can also experience amblyopia or lazy eye. Ptosis is a condition that can also slow or limit vision.

Causes of ptosis due to medical conditions

Eyelid ptosis can also be a sign of certain medical conditions, especially if both eyelids are affected.

If only one lid is drooping, this may be due to nerve injury or a temporary stye.

LASIK or cataract surgery can sometimes be the cause of ptosis, as a result of a pulled muscle or tendon.

In some cases, a stroke, brain tumor, or cancer of the nerves or muscles is the cause of ptosis. Neurological disorders that affect the nerves or muscles of the eye such as myasthenia gravis can cause this disease.

Other diseases that cause ptosis are:

• Tumors around or behind the eye
• Diabetes
• Horner's Syndrome
• Swelling of the eyelids, such as a pile or stye.

Risk factors

Some of the factors that can increase your risk of developing eyelid ptosis are:

• Aging
• Diabetes
• Stroke
• Horner's syndrome
• Brain tumor

Diagnosis & Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How is eyelid ptosis diagnosed?

The doctor will perform a physical examination and ask about medical history. Once you have explained how often the eyelids droop and how long the condition has been occurring, the doctor will perform several tests to see the cause.

The tests to diagnose ptosis are:

1. Slit-lamp inspection

Examination slit-lamp can be done so that the doctor can clearly see your eyes with the help of high-intensity light. Your eyes can be widened for this examination, you may feel a little discomfort.

2. Tensilon test

The doctor can inject a drug called Tensilon (generic name edrophonium) into one of the veins. You may be asked to cross your eyes or perform other eye movements that use the eye muscles.

Your doctor will monitor you to see if Tensilon is improving muscle strength. This can help determine if muscle problems are the cause of this condition.

3. Visual field test

This test can help detect ptosis problems on the eyelids. This test is also done to check for other eye conditions, such as glaucoma damage to the optic nerve and disease of the central or peripheral retina.

What are the treatment options for eyelid ptosis?

Treatment for eyelid ptosis depends on the cause. If this is due to age or birth, you may not need any treatment.

The doctor can explain that there is nothing that needs to be done as this condition usually does not endanger your health. To treat drooping eyelids that don't interfere with your vision, you may want to consider plastic surgery.

If the drooping of the eyelids has disturbed the view, there are several steps that can be taken to treat this condition, such as:

1. Glasses

If your eyelids block your vision, you will need medical treatment. One option that might be applied is the use of glasses that can hold the eyelids.

This treatment is most effective when the drooping of your eyelids is temporary, so you don't have to wear glasses all the time. Glasses are also recommended if you are not a suitable candidate for surgery.

2. Ptosis surgery

Ptosis surgery is performed under local anesthesia. Before surgery, be sure to tell your doctor about all the medicines you take.

Include all prescription medications, vitamins, and supplements. Your doctor also needs to know if you are taking aspirin or blood thinners.

Quoted from the Cleveland Clinic, surgery to correct this condition is divided into two types, namely:

• Makes an opening in the skin of the upper eyelid
  This procedure helps the doctor find the small muscle that should lift the eyelid. The doctor then places stitches to tighten this muscle and lift the eyelid. The incision in the skin of the eyelid is then closed with stitches.
• Perform the entire operation from the bottom of the eyelid
  In this procedure, the eyelids are turned back and the muscles are tightened from below. No skin incisions are required to perform this type of surgery.

After the operation, the doctor will tell you how to treat the eye. You are advised to return to the doctor, one week after surgery, so that the results can be checked.

Sometimes, the eyelids still droop a little or the eyelids don't close completely. If this is the case, you may receive additional treatment. However, the eyelids are usually in a better position, immediately after surgery.

Ptosis treatment in children

For children who have ptosis, the treatment the doctor may recommend is surgery to prevent amblyopia or lazy eye.

If the doctor sees that your drooping eyelids are caused by another condition, your child will undergo treatment that caused the condition. That way, the eyelids will stop drooping.

If you have any questions, consult your doctor for the best solution to your problem.