PTOSIS

Ptosis is the term used for drooping of the upper eyelids. Congenital ptosis which is more common and acquired ptosis Ptosis may involve one or both eyes and ranges from mild to severe In cases of mild ptosis the eye has an undesirable appearance but is functionally normal In severe ptosis the drooping upper lid covers the pupil and visual axis of the eye so the patient must lift his or her chin to see properly Congenital ptosis is present at birth and results from the poor development of the levator palpebrae superioris muscle which lifts the eyelid A child may have ptosis alone or may have other associated eye abnormalities such as eye movement disorders refractive disorders and neurological disorders Acquired ptosis may occur at any time after birth but is more common in old age The etiology of this form of ptosis is normally ascribed to the weakening of the levator palpebrae superioris muscle due to such factors as old age injury surgery muscular disease and neurological disease Symptoms Drooping of the upper eyelid of both eyes it may be mild or severe enough to cover the cornea Tired appearance of the eyes Undesirable facial appearance due to drooping of the upper eyelid Elevated chin in cases of severe ptosis Poor vision due to associated refractive errors Stiff neck due to constant chin elevation Decreased vision when the droop is severe and covers the pupil Treatment Ptosis results in an undesirable facial appearance Normal vision is affected in severe ptosis thus hindering the daily activities of the person Treatment is necessary even in cases of mild ptosis in order that the patient has the opportunity to lead life as a normal person A child suffering from ptosis has a psychological handicap when compared to other normal children Hence severe cases should be treated as early as possible otherwise ptosis may lead to abnormal head positions or decreased vision Treatment provides a desirable facial appearance as well as normal vision The treatment is surgery It usually involves one of the two procedures strengthening the levator palpebrae superioris muscle or lifting the eyelid mechanically with the help of a threadlike material called a sling Levator surgery is done in cases of mild or moderate ptosis while sling surgery is performed in cases of severe ptosis The levator muscle is strengthened by surgery so as to allow it to lift the eyelid normally During the initial period after surgery the patient may not be able to close his or her eyes fully even during sleep This malfunction results in a frightening appearance but is usually corrected within a few weeks Furthermore when the patient looks down the white of the eye may be visible The patient is trained to move his or her head to look down rather than to move only the eyes