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Ptosis repair

What is 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 in which the lid partially covers the pupil, or severe – in which the lid completely covers the pupil. Ptosis that is present at birth is called congenital ptosis.

Ptosis should not be confused with extra skin, fat or muscle of the eyelid, which are typically addressed with blepharoplasty surgery.  When ptosis can be shown to reduce peripheral vision significantly, its correction may be covered by your insurance.  If the degree of ptosis is not as severe, it may be corrected as a cosmetic procedure.

What causes ptosis?

In children, the most common cause is improper development of the levator muscle, the major muscle responsible for elevating the upper eyelid. In adults, the most common cause of ptosis is the weakening of the attachment between the levator muscle and the stiff portion of the eyelid.  This may occur as a result of the aging process, after surgery or trauma, or from chronic contact lens use. This may occur as a result of the aging process, after cataract surgery or contact lens wear, or from an injury.

As we age, the tendon that attaches the levator muscle to the eyelid stretches and the eyelid falls, covering part of the eye. It is not uncommon for a patient to develop upper eyelid ptosis after cataract surgery. In most cases, however, this may improve with observation.

Ptosis can also be caused by injury to the oculomotor nerve (the nerve that stimulates the levator muscle), or the tendon connecting the levator muscle to the eyelid.

How is ptosis treated?

The main goals of ptosis surgery are elevation of the upper eyelid to allow normal visual development and an improved field of vision, as well as improved symmetry between the two upper eyelids. It is important to realize that when operating on an abnormal muscle, completely normal eyelid position and function after surgery may not be possible to achieve.

Ptosis surgery is an outpatient procedure involving tightening of the muscle that lifts the eyelid. The surgical approach taken at OCLI depends on specific findings and testing performed during the preoperative evaluation. In many cases the excess skin or fat may be removed by performing a blepharoplasty at the same time. Your OCLI oculoplastic surgeon will discuss your treatment options fully and will perform all the proper testing to determine whether your ptosis is deemed medically necessary and will be covered by insurance.

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