Ptosis
Ptosis is a fairly common condition involving drooping of the upper eyelid. It is caused by a range of factors and in most cases affects only the patient's appearance.
While vision problems may not always arise, the condition does in practice cause the patient certain difficulties.
Without appropriate and timely treatment, it can lead to deterioration of vision and to the development of strabismus, amblyopia, and astigmatism. In some cases, inflammation of the conjunctiva and cornea is also observed. The child may complain of dryness and irritation in the eye, caused by incomplete closure of the eyelid.
Causes of ptosis
Various circumstances can cause drooping of the eyelid skin fold:
- Eye trauma
- Absence or underdevelopment of the muscle responsible for lifting the eyelid
- Age-related weakening of the muscle
- A neurological condition causing complete or partial paralysis of the oculomotor nerve or muscles
In the latter case, ptosis caused by neurological disease is acquired in nature. Multiple sclerosis, stroke, Horner syndrome, encephalitis, and other conditions can all cause the condition.
Eyelid deformity may also occur following trauma to the eye area.
Underdevelopment of the innervating muscle is frequently congenital and is caused by complications during pregnancy or childbirth, or by inherited genetic conditions.
Symptoms of upper eyelid ptosis
The condition may be congenital or may develop during life as a result of muscle weakening or damage to the nerve that innervates the muscle responsible for lifting the eyelid.
In addition to drooping of the eyelid skin fold, the following symptoms of ptosis are identified:
- Difficulty blinking
- A compensatory tilted-head posture
- Inability to fully close the palpebral fissure
In children, upper eyelid ptosis may be accompanied by the development of strabismus, astigmatism or amblyopia — the defect known as "lazy eye." Depending on the degree of eyelid drooping, vision impairment may also be observed in children.
Possible complications
When symptoms of ptosis are detected in children, a doctor should be consulted promptly!
Self-treatment is absolutely contraindicated if you wish to avoid complications such as strabismus.
Only an ophthalmologist can identify the causes of the condition and prescribe appropriate treatment.
The more pronounced the symptoms, the more frequently the patient tilts their head back to increase their field of vision.
Over time, the child develops a characteristic facial expression — with a furrowed brow, raised eyebrows, and a tilted head.
Treatment of ptosis
Ptosis treatment methods are selected individually by the specialist, taking into account the nature of the condition. In most cases, surgical intervention is necessary.
Surgery for upper eyelid ptosis is performed once the child has reached 3–4 years of age: when the eyelid covers 2/3 of the pupil (incomplete ptosis) or when the eyelid covers 1/3 of the pupil (partial ptosis).
If the condition is significantly affecting visual function, the surgeon may decide to operate earlier.
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Particular features of ptosis in children
In ptosis, the mobility of the affected eyelid may be significantly reduced or absent entirely. The condition causes restricted vision, as a result of which the person has to raise their eyebrows and tilt their head back. This posture is known as the "stargazer position" and is particularly common in children. Depending on the degree of ptosis and its complications, surgical correction is required at one stage or another.
When symptoms of this condition are detected in a child, a doctor should be consulted as early as possible. Ptosis impedes the normal development of the visual analyser, which negatively affects the quality of vision. Over time, strabismus, astigmatism, or amblyopia may develop.
Types of upper eyelid ptosis
Several classifications exist based on the cause, degree of symptom severity, and area affected. Most commonly, acquired and congenital ptosis are distinguished, as described above.
By degree of severity, the following types exist:
In addition, the condition may be unilateral or bilateral. The unilateral form is more common, in which case ptosis affects only one eye. The bilateral form affects both eyelids.
