Surgical treatment for drooping upper eyelid (Ptosis)
Ptosis is the medical term for drooping of the upper eyelid, a condition that may affect one or both eyes. When the edge of the upper eyelid falls, it may block the upper field of your vision. The ptosis may be mild (lid partially covers the pupil) or severe (the lid completely covers the pupil). Ptosis that is present at birth is called congenital ptosis.
Ptosis needs to be distinguished from Dermatochalasis (excess of skin in the upper eyelid). In some patients, both conditions may be present.
In children, the most common cause of Ptosis is improper development of the levator muscle, the major muscle responsible for elevating the upper eyelid. With adults, ptosis may occur as a result of aging, trauma, or muscular or neurologic disease.
Children with ptosis may also have amblyopia ("lazy eye"), strabismus (eyes that are not properly aligned or straight), refractive errors, astigmatism, or blurred vision.
The condition may be the first sign of myasthenia gravis, a disorder in which the muscles become weak and tire easily. Ptosis is also present in people with Horner's syndrome, a neurologic condition that affects one side of the face and indicates injury to part of the sympathetic nervous system.
Do you have ptosis?
Symptoms of ptosis include difficulty keeping your eyes open, eyestrain, and eyebrow aching from the increased effort needed to raise your eyelids, and fatigue, especially when reading. In severe cases, it may be necessary to tilt your head back or lift the eyelid with a finger in order to see out from under the drooping eyelid(s).
How congenital ptosis is treated
Congenital ptosis is treated surgically, with the specific operation based on the severity of the ptosis and the strength of the levator muscle.
Ptosis surgeries usually involve tightening the levator muscle to elevate the eyelid to the desired position. In severe ptosis, the levator muscle is extremely weak and a "sling" operation may be performed, enabling the forehead muscles to elevate the eyelid(s).
The main goals of ptosis surgery are elevation of the upper eyelid to permit normal visual development and a full field of vision, and symmetry with the opposite upper eyelid. It is important to realize that when operating on an abnormal muscle, completely normal eyelid position and function after surgery may not be possible.
In addition to the removal of the sutures, minor bruising or swelling may be expected and will likely go away in one to two weeks. Bleeding and infection, which are potential risks with any surgery, are very uncommon. As with any medical procedure, there may be other inherent risks that should be discussed with your surgeon.
Your surgery will be performed by Dr. Oestreicher, a surgeon who is not only a board certified ophthalmologist, but also has had extensive training in ophthalmic plastic surgery.
"The problem with my eye is solved"
When I was first referred to Dr. Oestreicher I had my doubts that he could help me with a problem I have had since childhood because I have had many doctors who said that they could not correct the problem (I am now in my fifties), but Dr. Oestreicher did as promised. The problem with my eye is solved. He was just great, there was no problem if I needed an urgent follow up appointment. His staff were just great, friendly and efficient.