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Ptosis

Ptosis refers to the drooping of an eyelid, and it affects only the upper eyelid of one or both eyes. Ptosis can affect one eye or both eyes. The eyelid is often carefully compared to the opposite eye in terms of lid height in awake patients, however, this is not possible in patients under general anesthesia (infants and young children).Ptosis may be present at birth, or it may develop later in life In children with poor levator muscle function, a "levator sling" may be used.In some cases, it may be associated with a crossed or misaligned eye ( strabismus ).When a neurological disorder is present, symptoms typically include visual complaints independent of the droopy eyelid.Difficulty reading and driving are common complaints.Raising the entire brow with the muscles of the forehead and scalp may cause headaches and eyestrain as well. In newborns, this problem must be addressed and treated properly to insure normal maturation of the visual system and the avoidance of amblyopia (lazy eye).If the lid droops enough to partially cover the pupil, the person attempts to compensate by raising the eyebrow and/or by tilting the head back. Patients with ptosis often have difficult blinking, which may lead to irritation, infection and eyestrain. If a sudden and obvious lid droop is developed, an ophthalmologist should be consulted immediately.  

Ptosis (pronounced toe' sis), or drooping of the upper eyelid , may occur for several reasons such as: disease, injury, birth defect, previous eye surgery and age In most cases of congenital ptosis, the problem is isolated and does not affect the vision. Any ptosis that develops over a period of days or weeks can signal a serious medical problem and needs further neurologic and physical evaluation.The droop may be barely noticeable, or the lid can descend over the entire pupil .Ptosis can also be caused by a malfunction of the nerves which control and activate the eyelid muscles.These cases are rare and proper diagnosis is important in order to avoid unnecessary surgery. This is a more complex procedure in which muscles of the brow or forehead may be used to assist in elevation of the upper eyelid. Patients with ptosis often have difficult blinking, which may lead to irritation, infection and eyestrain .This results in the inability to close the eye completely after surgery. Such a situation creates a dry eye condition that may be difficult to manage.Almost invariably in these cases, the unoperated eyelid will appear lower after a successful repair of the first eye.Once the lid height is secured in the desired location, the eyelid incision is closed with tiny sutures. One or both eyes may need to be treated. 

Causes of Ptosis

The common causes of ptosis :

• This condition consists of short palpebral fissures, congenital ptosis, epicanthus inversus, and telecanthus.
• Plexiform neuromas, lymphomas, leukemias, rhabdomyosarcomas, neuromas, neurofibromas, or other deep orbital tumors may produce ptosis or proptosis.
• Ptosis can also be caused by a malfunction of the nerves which control and activate the eyelid muscles or a problem with the nerve that sends messages to the muscle.
• If the sympathetic pathway is lesioned, there is impaired transmission to Müller's muscle , a small muscle that sits above the upper lid tarsal plate.
• A defect at the neuromuscular junction produces relative unresponsiveness to released acetylcholine, resulting in ptosis.
• Drooping eyelid can be caused by the normal aging process, a congenital abnormality (present before birth), or the result of an injury or disease.
• It can also be cause by injury or trauma to the eye as in an accident.

Symptoms of Ptosis

Some common Symptoms of ptosis :

• Drooping of one or both eyelids
• Crossed or misaligned eye and sometimes double vision occurs.
• Increased tearing
• Raising the entire brow with the muscles of the forehead and scalp may cause headaches and eyestrain as well.
• If ptosis is severe, interference with vision.
• Children who are born with a ptosis usually tilt their head back in an effort to see.
• Difficulty closing the eye completely
• Eye fatigue from straining to keep eye(s) open
• Children may tilt head backward in order to lift the lid
• Double vision

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