Ptosis

If your child has congenital ptosis, the sooner you have it treated, the better. If left untreated, it could impact their vision development and lead to other issues. Mild acquired ptosis is less likely to cause vision problems, and you may not need to seek treatment. But severe ptosis can cause serious complications if you don’t treat it. Complications of ptosis may include:

• Astigmatism: When your eyelid puts pressure on the front of your eye, it can change the shape of your eye. This can cause distortion in your vision (your vision may be stretched or wavy).
• Amblyopia: Astigmatism and other refractive errors (issues focusing due to a need for glasses) can cause amblyopia, or lazy eye.
• Chin-up position: When your child has to tilt their chin up to be able to see beyond their drooping eyelids, it can cause neck problems, tightened forehead muscles and developmental delays.

Ptosis can affect both children and adults.

• Congenital ptosis: Congenital ptosis means your child was born with the condition. Problems with the development of the levator muscle cause congenital ptosis.
• Acquired ptosis: This type of ptosis affects adults later in life. It occurs when your levator muscle weakens or separates away from your eyelid.

Ptosis causes depend on the type. Some babies are born with ptosis in one or both eyelids (congenital ptosis).

Ptosis can occur later in life (acquired ptosis) if the muscles or ligaments that normally raise your eyelid are weakened by injury or disease. Sometimes, the drooping is a result of damage to the nerves that control your eyelid muscles.

Diseases and conditions that may result in ptosis include:

• Stye.
• Horner syndrome.
• Myasthenia gravis.
• Stroke.
• Tumor.
• External ophthalmoplegia.

Most ptosis just happens with aging. As you age, the skin and muscles of your eyelids stretch and weaken. Sometimes, previous eye surgery speeds up this change because the instruments used to keep your eye open during surgery can stretch your eyelid.

You can typically tell if you or your child has ptosis by your eyelid’s appearance. It may cover only the upper eye, or it may cover the entire pupil. Other ptosis symptoms may include:

• Excessive rubbing of your eyes.
• Increased tearing.
• Decreased or impaired vision.
• Tiredness and achiness around your eyes.
• Children may tip their heads back to see.

Ophthalmologists can typically detect ptosis by the appearance of a drooping eyelid. If both eyelids are affected, it may be more difficult to diagnose.

Tests that your doctor may perform include:

• Slit lamp examination.
• Visual field testing.
• Ocular motility (eye movement) test.
• Tensilon test (uses the drug Tensilon, also known as edrophonium, to diagnose myasthenia gravis).