Ptosis is a term that describes drooping or sagging of the upper eyelid.
The upper eyelid can droop or sag for different reasons. Most cases are either due to a problem with the muscles that move the eyelid, or the nerves that attach to those muscles. Some of the causes of a sagging eyelid are life threatening, while others only alter the person's appearance.
A drooping eyelid is usually noticed by the affected person, or the parents of an affected child. The affected eye is usually less open than the normal eye, although the condition can occur in both eyes. Drooping may be the only symptom. All other symptoms are related to the underlying cause. In cases of nerve damage, blurry or double vision may occur and the pupil may be abnormally small or large compared to the other eye. If muscle weakness is the cause, there may be muscle weakness in other areas of the body.
There are many potential causes of sagging of the upper eyelid, including: inherited defects or defects present at birthold age. In this case, the muscles grow weaker and there is a loss of eyelid support that gradually occurs over time.muscle weakness or damage. This may be due to inherited muscle diseases, the use of certain topical medications to the eye, or myasthenia gravis (MG). MG is a condition that causes muscle weakness in most of the body because a person's immune system attacks the muscles.damage to one of two nerves that attach to the upper eyelid muscles. This nerve damage can be present at birth or can happen later in life.
Possible causes of acquired nerve damage include: tumors or cancer, which may be inside the skull or in the neck or lunginjuryan abnormally widened artery inside the skull, which is a potentially life-threatening probleminflammation of the nerve, such as from an infection or from the immune system attacking the nerve for unknown reasons
Most of the risks are related to the underlying cause. For example, if the cause is aging, the condition poses no risks. If the cause is cancer, death may occur.
Good control of diabetes and high blood pressure can prevent some cases of a drooping upper eyelid. Lung cancer is a fairly uncommon cause of a drooping eyelid. This disease can usually be prevented by not smoking. Many cases cannot be prevented.
The affected person usually notices this condition. With children, the parents often notice. Sometimes, the cause is obvious to the healthcare professional from the history and physical exam. In other cases, special testing may be needed. These may involve blood tests, special X-ray tests, or possibly a biopsy. In a biopsy, a small piece of tissue is removed from the body. A lab then examines the tissue sample.
Most long-term effects are related to the underlying cause. Some cases of a droopy eyelid have no long-term effects. Other causes may result in death, such as cancer or an abnormally widened artery inside the skull.
In children younger than 8 years old, a sagging upper lid can be serious no matter what the cause, because the child may not develop proper vision in the eye with the sagging lid. Without treatment, this can result in permanently reduced vision or even blindness. If this occurs, glasses will be unable to correct the problem. Prompt treatment prevents this long-term effect.
There are no risks to others. This is not a contagious condition.
This partly depends on the cause. For example: If high blood pressure or diabetes is the cause, no treatment is required. The condition goes away on its own, usually within two months. Tighter control of diabetes and high blood pressure is stressed.If a tumor or cancer is the cause, surgery, radiation treatment, or chemotherapy may be needed.If a widened artery in the skull is the cause, surgery or some other procedure may be needed.An infection may need to be treated with antibiotics.If MG is the cause, drugs can be given to improve muscle strength to minimize the drooping of the lids.In the case of young children affected for any reason, surgery is often advised to prevent vision problems.In the case of injury or aging, no treatment is needed. Those who dislike the appearance of their eyelids can opt for surgery.
Surgery generally involves tightening or shortening the muscles of the upper eyelid to physically pull the lid into normal position.
All medications have possible side effects. These include allergic reactions, stomach upset and other side effects. Specific side effects depend on the drugs used. Surgery can be complicated by infection, bleeding, or reactions to anesthesia.
In many cases, a person can return to normal activities. If surgery is performed, a person can go home shortly after the procedure. Recovery takes only a few days in most cases. Children and those with serious underlying causes need further monitoring.
Children need repeated eye exams before and after treatment to check for vision loss. Other monitoring depends on the underlying cause. In the case of injury or aging, no further monitoring is needed.
