Ptosis is a condition in which the upper eyelids lose their elasticity, causing them to droop over the eyes. The condition reduces the range of vision and causes a tired appearance. Ptosis repair lets the patient open their eyes wide once again, restoring their range of vision and youthful appearance.
For the best results, it's recommended to visit an opthamologist as early as possible, even if you do not plan to have surgery right away. Droopy eyelids cause stress to the levator muscles which are in charge of opening and closing the eyes, and may lead to atrophy over time. Seeking treatment early provides more options and increases the odds of a full recovery.
Ptosis most commonly occurs over a period of years as a result of aging, although it may also occur at any point in a person's life, including birth, due to lack of strength in the levator muscles. Ptosis is also a possible side effect of eye surgery, particularly cataract removal.
When ptosis develops quickly and without a known cause, it may be a sign of a neurological disorder such as epilepsy or Parkinson's disease. If you or a loved one develop ptosis without a known cause, please visit a doctor in order to catch symptoms early.
Depending on the severity of ptosis, the age of the patient, and the strength of the levator muscles, different methods are used to restore functionality of the eyelids. Surgery is generally performed as an out-patient procedure with local anesthetic, sometimes with a light sedative. After surgery, patients are recommended to get plenty of rest and take a week off from strenuous activity.
When the levator muscles still have strength but are struggling to perform and need extra leverage, the muscle is tightened through levator resection surgery. The total length of the muscles is reduced between 10 and 30 millimeters in order to help the eyes open and close naturally. During recovery, you may have trouble blinking. Your opthamologist will provide recommendations for keeping your eyes moist and healthy until your levator muscles regain strength.
In some cases, the levator muscles are not strong enough to support the eyes. In this case, an organic lever is built between the eyelid and the brow, allowing the patient to widen their eyes using their forehead muscles.
While the levator muscles are the most common targets of ptosis surgery, other muscles around the eyes can be tightened in order to assist with eyelid functionality. Ptosis surgery may tighten the aponeurosis tendon which holds the levator muscles in place, or the Muller's muscle which braces the aponeurosis tendon. When the ptosis is very slight and the levator muscles are healthy, several small muscles may be removed to keep the eyelid's full range of motion from being restricted. This surgery is known as the Fansanella-Servat procedure.
Ptosis surgery is often performed along with blepharoplasty, an outpatient surgery which removes built-up fat tissue above and below the eyelids. Excess weight over the eyelids may aggravate ptosis, so the two surgeries may be planned in accordance with each other for the best lasting results.
When ptosis occurs in infants and young children, it's not always necessary to intervene right away. If a young child has trouble walking and performing day-to-day activities due to their field of vision, outpatient surgery is sometimes encouraged. However, many families choose to wait in order to make the surgery easier and less stressful for the child. An opthamologist will meet with your family decide together on the best course of action.
There are many factors which determine the speed and severity of ptosis, meaning the ideal treatment options also vary greatly. Please visit us at Bellingham Eye Physicians to find the best solution for you.