A droopy eyelid, medically known as ptosis, is an eye condition characterized by an upper eyelid drooping over the eye. It is possible that this condition can affect only one eye, or is evident in two eyes – called unilateral ptosis and bilateral ptosis, respectively. In mild cases, the droop may be barely noticeable – it would appear as if the person is just sleepy-looking. However, for some severe cases, the lid can descend entirely over the pupil causing blocked vision.
A ptosis may not necessarily be considered a medical emergency, but may cause the following:
- Negative effect on physical appearance as it gives one a sleepy and inattentive look
- Inconvenience as people with it will try to tilt their heads up to be able to see or will try to lift their eyebrows repeatedly to lift the eyelids
- Limited or complete vison loss (in the long run)
- Other eye problems such as amblyopia or lazy eyes, if taken for granted
A person can develop ptosis from childbirth, categorized as congenital ptosis, or it can develop at any time within a lifetime, known as acquired ptosis. Fortunately, ptosis surgery in Singapore, both for children and adults, is available. This type of surgery is available in eye clinics or clinics specializing in reconstructive surgery, such as Allure Plastic Surgery, headed by consultant plastic surgeon, Dr. Samuel Ho.
So if you think you or maybe your child has ptosis, this article will help you be informed and get you started on what to do. Below are its causes, risks, symptoms, diagnosis, and surgical treatment – plus answers to some frequently asked questions especially of parents who have children with ptosis.
A congenital ptosis is often caused by a problem in the child’s levator muscle or the muscle that lifts the eyelid. It is possible that the certain muscle has not developed properly in the womb. Whilst, for acquired ptosis, adults who acquire it usually have weak nerves that control the eyelids due to various causes such as:
- Aging, considered as the most common cause because when we age, the skin and muscles around the eyes also weaken
- Trauma caused by injuries may cause the muscles and skin to sag and weaken
- Side effect of other existing eye condition like eye tumor
- Symptom of some underlying medical conditions like myasthenia gravis, a rare condition that affects the muscles
- After effect of eye surgeries such that of cataract surgery and LASIK treatment
The most obvious sign of ptosis, of course, is a droopy eyelid. However, you might also have some of these symptoms:
- Difficulty in blinking or closing the eye
- Eye Fatigue
- Double Vision
- Crossed eyes
If these symptoms are experience, it is best to consult with your trusted doctor.
A ptosis caused by aging is easily noticeable. One way to determine is it to compare an old photograph of you to a more recent one. Changes of the sagging or drooping of the upper eyelid will be noticed that might confirm you have the condition. However, to be sure, a good visit to the doctor may help you get diagnosed for ptosis.
To diagnose a ptosis, the doctor may do the following:
- Conduct physical exam
- Ask questions regarding your medical history
- Perform a comprehensive eye exam to know the length and degree of the droopiness of your eyelid which may be any of the following:
- Visual Field Test – a test to evaluate your superior muscle
- Slit Lamp Exam –this test uses high intensity light to take closer at your eye
- Tensilon Test – in this test, you will be injected with a drug called Tensilon into one of your veins. This test will help your doctor determine if your ptosis is caused by myasthenia gravis
To correct ptosis, surgery is the most recommended by doctors. Blepharoplasty is the general term for surgically correcting defects, deformities, and disfigurations of the eyelids either for functional reasons, cosmetic reasons, or both. In the case of a ptosis, it is both functional and cosmetic reasons (especially for adults).
The approach of the surgery will depend on the cause of your ptosis and of course. In addition, the doctor will take into consideration your overall health. At the same time, approaches to the treatment will also be different for adults and children.
For children, surgery is much recommended. If ptosis is evident while still young, undergoing surgery will prevent the onset of amblyopia or lazy eye.
Surgery for ptosis is usually done as an outpatient procedure, meaning you can go home after the surgery. A local anesthesia will be administered before the surgery proper so that your eyes and the surrounding areas will be numb. It will only then when your surgeon will adjust or lift your upper eyelid. Usually, a ptosis procedure is combined with upper eyelid blepharoplasty. In this combined procedure, the levator muscle is repositioned and the eyelid height is adjusted or lifted. Once the upper eyelid is lifted on your desired height, the excess skin and fat are removed.
Frequently Asked Questions (by Parents of Children with Ptosis)
- At what age can an infant or a child with ptosis undergo surgery?
Answer: If vision is not affected, surgery can wait until the child is aged 3-5, as he/she has grown a little bigger.
- What will happen to my child if ptosis is not treated?
Answer: Your child may develop lazy eyes, and will have a lifetime of poor vision. It is also possible that the child will develop astigmatism, where they see blurry vision.
- What are the risks for my child if he/she will undergo surgery to treat ptosis?
Answer: Just like any other surgery, surgical treatment for ptosis also has risks that apply to both children and adults who underwent it. The risks of ptosis surgery include infection, bleeding and reduced vision, but these complications occur very infrequently. Also, after surgery, your eyelids may not be symmetrical anymore.
- To whom shall I go if I think my child has ptosis?
Answer: It is best to consult with trusted eye surgeons and plastic surgeons who have handled cases of ptosis. Allure Plastic Surgery, headed by consultant plastic surgeon, Dr. Samuel Ho, is clinic in Singapore which specializes in reconstructive surgery, including ptosis.
Allure Plastic Surgery
435 Orchard Rd, #22-04 Wisma Atria,
+65 6734 9988