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Ptosis

Ptosis: Causes, Symptoms, Diagnosis, Treatment, and Prevention

Ptosis is a condition in which the upper eyelid droops over the eye. Sometimes, it can interfere with vision. The condition is more common in older people, but it can occur in children too. Ptosis can occur in either eye or both eyes at the same time.

Symptoms of Ptosis

The most obvious sign of ptosis is drooping of the eyelid. Other symptoms include:

  • Difficulty closing the eye or blinking

  • Tearing

  • Eye fatigue

  • Trouble seeing (because of this, a person may tilt their head back in order to see under the eyelid)

  • Children with ptosis may have additional symptoms, such as:

    • Amblyopia, sometimes called lazy eye because one eye seems to look off in another direction

    • Nearsightedness, farsightedness, or astigmatism

    • Double, blurred, or distorted vision

    • Eye strain, headaches, or dizziness

Causes and Risk Factors of Ptosis

Ptosis can be caused by different factors that affect the eyelid muscles or the nerves that control them. These include:

  • Aging, which can cause the eyelid muscles (called levator muscles) to weaken

  • Congenital ptosis, where the levator muscle doesn’t fully develop during pregnancy

  • Injury, trauma, or infection that damages the levator muscle or the nerves

  • Skin looseness above the upper eyelid

  • Tumor behind or around the eye

  • Disease like diabetes, stroke, myasthenia gravis, and Horner syndrome that affect the nerve function

  • Cosmetic treatment with Botox, which can sometimes cause ptosis

Diagnosis of Ptosis

Your eye doctor will examine your eyelids closely for signs of ptosis. They will measure how high your eyelids are and how strong the muscles are. In addition, they can perform a computerized visual field test to determine your vision is normal. In a visual field test, you are asked to look at a series of flashing lights in a machine, without moving your eyes. You must push a button when you see a light.

Treatment of Ptosis

Adults with no trouble seeing or who don't care about how their eyelids look don't need treatment for ptosis. The most common treatment for ptosis is a surgical procedure called a ptosis repair. Using a local anesthetic, the surgeon numbs the area around your eyelid. The surgeon then makes a small cut on your upper eyelid, tightens the levator muscle with stitches, and then closes the incision with more stitches. Surgery to correct ptosis may be combined with a blepharoplasty, which removes excess eyelid skin that contributes to droopiness. Sometimes the eyebrows may also be lifted.

Prevention of Ptosis

There is not any possible way to prevent ptosis, as it can be caused by various factors that are not under your control. However, you can take some steps to protect your eye health and vision, such as:

  • Avoid rubbing or pulling your eyes excessively

  • Wear sunglasses to protect your eyes from sun damage

  • Manage your blood sugar levels if you have diabetes

  • Seek medical attention if you have any signs of infection, injury, or disease that affect your eyes

  • Go for regular eye checkups and vision tests

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