Droopy Eyelids? You May Have Ptosis
Ptosis happens when the upper eyelid sags over the eye. The condition can occur in one or both eyes and may affect vision if the eyelid covers your pupil. Fortunately, your ophthalmologist offers treatments that may correct the problem or help you manage it.
Who Gets Ptosis?
Ptosis can affect both adults and children and may range from mild to severe. Although mild ptosis may make you feel self-conscious about your appearance, it won't cause vision problems. Severe sagging interferes with vision, making it difficult to spot obstacles when walking or driving.
Ptosis Causes in Children
Congenital ptosis is the most common type in children, according to Stat Pearls. The condition is present at birth, although symptoms may not be obvious immediately. Congenital ptosis may affect one or both eyes. Drooping happens due to improper development of the levator muscle that lifts the eyelid.
The American Academy of Ophthalmology (AAO) notes that children with ptosis may tilt their heads, lift their chins, or raise their eyebrows to see better. Eventually, this can lead to poor posture and neck and head issues.
If drooping eyelids interfere with vision, children may develop amblyopia (lazy eye), strabismus (crossed eyes), or astigmatism. Strabismus happens when the eyes are misaligned, while amblyopia occurs when the brain only processes information received from one eye. Without treatment, strabismus and amblyopia can cause delays in vision development.
Astigmatism is a type of refractive error that happens when the clear cornea over the iris and pupil is irregularly shaped. The error causes blurry vision whether your child is looking at objects nearby or in the distance.
Injuries and diseases may also cause ptosis in children.
Ptosis Causes in Adults
Ptosis in adults usually occurs due to aging. According to the American Society of Ophthalmic Plastic and Reconstructive Surgery, the tendon that connects the eyelid to the levator muscle stretches as you get older. You may struggle to keep your eyes open if you have age-related ptosis or notice that your droopy eyelids decrease your field of vision. In fact, you may need to use your hand to prop your eyes open if drooping is severe.
Ptosis may also occur after eye surgery or following an injury. In some cases, ptosis in adults may be caused by myasthenia gravis, Horner's syndrome, stroke, tumors, cranial nerve 3 palsy or another disease or condition.
Treating Ptosis
Surgery is usually needed to treat ptosis in children. Without it, children may face lingering or permanent changes to their vision. During surgery, ophthalmologists shorten the levator muscle or connect the eyelid to forehead muscles. If your child is born with ptosis, surgery may be delayed a few years, providing the condition doesn't interfere with vision.
If you're an adult, your ophthalmologist may recommend using prescription oxymetazoline drops every day to treat ptosis. The drops help the levator muscles raise the eyelid. Although oxymetazoline drops can be helpful, they won't improve sagging caused by a nerve problem or injury, according to the AAO.
Surgery is also an option for adult ptosis. During the surgery, your eye doctor adjusts or shortens the levator muscle. Although ptosis surgery for cosmetic reasons isn't usually covered by health insurance, your insurance plan may cover all or some of the procedure if your sagging eyelids interfere with your vision.
Is ptosis a problem for you or your child? We can help you explore treatment options. Contact our office to schedule an appointment with the ophthalmologist.
Sources:
Stat Pearls: Congenital Ptosis, 4/3/2023
https://www.ncbi.nlm.nih.gov/books/NBK568688/
American Academy of Ophthalmology: What Is Ptosis?, 11/11/2024
https://www.aao.org/eye-health/diseases/what-is-ptosis
MedlinePlus: Eyelid Drooping, 7/9/2024
https://medlineplus.gov/ency/article/001018.htm
American Society of Ophthalmic Plastic and Reconstructive Surgery: Droopy Eyelids
https://www.asoprs.org/droopy-eyelids--ptosis-
American Academy of Ophthalmology: YO Need to Know: 5 Causes of Dangerous Asymmetric Ptosis, 5/16/2023
Cleveland Clinic: Ptosis (Droopy Eyelid), 8/9/2023
https://my.clevelandclinic.org/health/diseases/14418-ptosis-droopy-eyelid