Eyelid ptosis is a condition that causes the eyelid to droop. It often interferes with vision when the lid droops to the point where it covers the pupil. Eyelid ptosis can occur anytime from birth to old age and can affect one or both eyes.
Congenital ptosis occurs at birth. Surgery might eventually be needed to correct the condition if it interferes with sight. Age-related ptosis, or aponeurotic ptosis, is the most common ptosis that is caused by the long-term effects of gravity pulling the tissue in the eyelid. Eyelid ptosis also can be caused by myasthenia gravis, a muscle disease that affects the eyelids and other parts of the body.
Common ptosis is asymptomatic. There are no symptoms except droopy eyelids that might or might not interfere with vision. Other symptoms might indicate a more serious condition, such as myasthenia gravis. Double vision; difficulty speaking, swallowing or breathing; and muscle weakness can be indicators.
A qualified physician should complete diagnostic testing before any treatment for eyelid ptosis is undertaken. A review of symptoms, medical and family history; an eye examination; and physical and neurological exams can all be expected. If the physician discovers indicators of a more serious cause for ptosis during the examination, further testing will be needed.
The slit-lamp exam might be used in the examination process. The test looks at the condition of the eyelid, lens, cornea and other areas of the eye to determine whether disease is present. Eye drops are the only medication used for the slit-lamp exam, leaving the patient with temporarily dilated pupils. The tensilon test also might be administered if myasthenia gravis is suspected. It involves administering medication intravenously to determine muscle weakness and strength.
Treatment options are presented after professional diagnosis. Drooping eyelids that are caused by aging and do not interfere with vision do not require treatment. Ptosis, that does impede sight, can be corrected with a simple outpatient surgery called blepharoplasty. This procedure removes fat, muscle and excess skin under local anesthesia. Some swelling and bruising can be expected after this surgery.
A qualified physician should closely monitor babies born with congenital ptosis. If the condition is not severe, a series of exercise might be recommended to reduce the risk of the child developing amblyopia, or lazy eye. Surgery likely will be recommended when the child is older.
There is no cure for myasthenia gravis, but remission is possible. The condition is often managed with lifestyle and dietary changes and medication. Treatment options for eyelid ptosis that occurs because of myasthenia gravis should be discussed with a physician.