Ptosis is a common problem found in people of all ages and varies in severity. If you notice that your eyelid fold is starting to droop, Dr. Fontip Na Pompet, an ophthalmologist at the Eye Clinic, Phyathai 2 Hospital, recommends that early detection and prompt treatment can help reduce the impact on vision and increase the chances of successful corrective surgery to restore a normal appearance.
What is Ptosis?
The eyelid is an organ that helps protect the eye from potential harm. It shields the eye from sunlight, bright light, electric light, dust, and foreign objects that could damage the cornea. Ptosis is a condition where the skin of the eyelid droops and obstructs vision. Normally, the upper eyelid should cover no more than 2 millimeters of the pupil. If it droops more than that, it reduces the visible area of the pupil.
Causes of Ptosis
Divided into 2 groups:
1. Congenital Group
Ptosis in newborns may be caused by abnormal eyelid muscles present from birth. It is a hereditary condition and can lead to amblyopia (lazy eye), which is a secondary condition caused by ptosis. The symptom of amblyopia is that when the eyelid droops and blocks vision, the child will not use that eye, causing the affected eye to not develop properly. Normally, a child’s vision develops to adult levels through visual stimulation until about 6 years old to fully develop the optic nerve.
Therefore, if you suspect that a child has ptosis or amblyopia, you should promptly see an ophthalmologist to assess the severity and determine if surgery is needed. In some children with mild symptoms who do not want surgery, eyelid tape may be used to lift the eyelid and encourage the child to use that eye. However, if taping does not improve the condition and the eyelid continues to droop, it will hinder proper visual development, causing the eye to remain underdeveloped and potentially leading to strabismus.
2. Acquired Group
- Caused by muscle abnormalities or various acquired causes such as eyelid trauma, eyelid inflammation, and eyelid muscle weakness.
- Caused by behaviors that stretch or injure the muscle such as allergic eye reactions, frequent eye rubbing, wearing contact lenses with inappropriate curvature, allergic reactions to contact lenses due to poor cleaning, or prolonged contact lens use.
- Caused by problems with the third cranial nerve or tumors pressing on the optic nerve leading to ptosis or muscle weakness.
- Complications from eye surgery or cosmetic surgery around the eyes that affect the muscles responsible for opening the eyelid.
- Age-related causes where the attachment of the eyelid muscles deteriorates and loosens.
Symptoms indicating ptosis
- The eyelid fold starts to droop with the upper eyelid lowering more than normal, reducing vision and causing multiple eyelid folds.
- Eye irritation such as burning, itching, or a heavy sensation in the eyelid.
- When looking in the mirror, the eye cannot open fully and the visible pupil area is reduced.
Treatment Methods
Treatment can be done in 2 ways:
- Symptomatic medication such as artificial tears for dry eyes. Some types of eyelid muscle disorders can be treated with medication to reduce symptoms.
- Surgical treatment involves surgery to strengthen the eyelid muscles and improve eyelid opening. Generally, stitches are removed one week after surgery, and improvement of about 70-80% is seen after approximately 2 weeks. The eyelid fold will naturally improve over 3-6 months. After surgery, it is important to monitor whether the eyelid closes and opens naturally and aesthetically. In some patients, it may not be possible to make both eyelids identical because the balance between opening and closing must be maintained, but the doctor will help achieve the best possible appearance close to the original.
Dr. Fontip Na Pompet
Ophthalmologist specializing in orbital diseases
and oculoplastic surgery
Eye Center, Phyathai 2 Hospital
