If asked about a medical problem that can affect the eye, many people would probably think about traumatic injuries or age-related diseases. But not every medical problem that interferes with our ability to see develops within our actual eyes. An example of such a problem is ptosis.


“Ptosis” refers to a phenomenon where the upper eyelid begins to droop. While this may not initially sound like a big problem, ptosis can actually become so severe that it interferes with a patient’s ability to see and go about their daily life in a normal manner. Seeing as this medical problem affects both adults and children, it’s important to know what causes this issue and to understand what treatment will be needed to address it.


Congenital_ptosis.JPG What Causes Ptosis?


There are multiple possible causes of ptosis. A common cause is the weakening of the muscles that control the eyelid; this weakening can occur in the muscles of both adults and children.


In adults, ptosis tends to develop because a tendon that attaches to the levator muscle – that is, the key muscle involved in lifting the eyelid – is stretched and weakened to the point that it no longer effectively pulls on the muscle. In children, it’s a delayed development of some sort that usually results in the levator muscle being too weak to do its job effectively. No matter what the cause of ptosis is, however, patients eventually suffer from sagging in one or both eyelids.


While weakened muscles are the most common cause of ptosis, it can also develop for other reasons. Alternatively, some neurologic or muscular diseases can affect the muscles and nerves in the eyelid and lead to ptosis. A traumatic event that affects the eye can also increase the risk of developing this condition. In some cases, ptosis may be inherited. Finally, cataract surgery may lead to stretching of the muscles and tendon that are used in controlling the eyelid, and can contribute to the risk of developing ptosis.


Why Is Ptosis So Problematic?


While some cases of ptosis only result in a minor drooping of the upper eyelid, in other cases the eyelid can reach so low that it covers the entire pupil of the eye. This means that these extreme cases of ptosis can restrict or even completely block someone’s normal field of vision.


Unfortunately, those affected by ptosis often have trouble keeping their eyelids fully open and compensating for the sagging in their eyelids. Some individuals will even find that they need to use their hands and fingers to keep their eyelids raised so that they can see.


Who Is Affected By Ptosis?


Ptosis can affect both adults and children. Unfortunately, children with ptosis are at risk of developing additional complications, including amblyopia (also known as a “lazy eye”). Some children may also experience a developmental delay due to their limited vision, if the problem is not corrected. Worse, children already dealing with ptosis are at a higher risk of suffering from other eye-movement abnormalities.


Can Ptosis Be Corrected?


Yes. Ptosis can be corrected surgically during a procedure that tightens the levator muscle or Mueller’s muscle; this tightening then gives the individual an improved ability to lift their eyelid. In extreme cases, surgeons may carry out an operation known as a “frontalis sling” operation, which gives a patient’s forehead muscles control over the eyelid and can help return a patient’s field of vision to normal. Either way, the surgeon in charge will aim to give their patient full control over their eyelids and a full field of vision after treatment.


While ptosis is not the most common medical eye problem that may affect your eyes, it is an issue that can interfere with your daily life without proper medical treatments. If you notice that one or both of your eyelids, or your children’s eyelids, are beginning to droop, schedule an appointment with your eye doctor immediately. They will be able to refer you to a specialist if needed, and will be able to help you return your vision to a state of normalcy.

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