Drooping of the eyelid (ptosis)

Заболевания. Птоз века.
Ptosis
is a relatively widespread pathology of drooping of the upper eyelid. It is occurs due to various reasons and often affects only the appearance of a patient. Although the functional problems with vision are quite rare, the pathology provides for certain inconveniences.

Development of ptosis in children

Mobility of the affected eyelid can be significantly decreased or even terminated due to ptosis. The pathology interferes with the patient’s vision and the affected person needs to raise brows and throw back head. This is the so-called astrologist’s posture and it can be often seen at children with ptosis. Depending on the grade of the disease and the complications combined with ptosis surgical correction could be required on certain stages.

Shall the symptoms of this pathology be evident in a child, it is highly recommended to contact the doctor as soon as possible. Ptosis of the eyelid negatively affects the development of the visual analyzer and therefore impairs the quality of vision. Eventually it can result in strabismus, astigmatism or amblyopia.

Diagnostics of ptosis of the upper eyelid

The pathology can be congenital or occur during the patient’s life due to dysfunction of the muscles and damage to the nerve innervating the correspondent levator muscle.

Along with the drooping of the eyelid there are several other symptoms of ptosis:

  • difficulties at winking;
  • forced upward head posture;
  • impossibility to fully close the eye fissure.

Ptosis of the upper eyelid in children can be accompanied by strabismus, astigmatism or amblyopia – the defect known as lazy eye. Depending on the grade of fading of the skin fold the children can face visual impairment.

Classification of ptosis of the upper eyelid

There are certain characteristics of the pathology depending on its etiology, intensity of symptoms and affected areas. In most cases there is a difference between acquired and congenital eyelid ptosis.

Depending on the grade of the symptoms there are the following types of ptosis:

  • complete ptosis (skin fold covers the pupil);
  • incomplete ptosis (skin fold covers 2/3 of the pupil);
  • partial ptosis (skin fold covers only one third of the pupil).

The pathology can be one-sided and both-sided. First type occurs more often: in this case ptosis occurs only on one eye. Both-sided ptosis occurs on two eyelids.

Myths

Myth:
Ptosis of the eyelid is generally a cosmetic defect.

Truth:
Impairment of visual function is a very rare event in case of ptosis. Usually the drooping of the eyelid is considered to be a cosmetic defect.

Etiology of the development of ptosis

Женщинам во время вынашивания ребёнка следует соблюдать осторожность, так как врождённый птоз века способен развиться в результате родовой травмы. Если у вас имеются родственники с данным заболеванием, рекомендуется обследовать новорождённого у врача-офтальмолога.

Different conditions may provoke drooping of the eyelid:

  • eye trauma;
  • absence of the levator muscle or its underdevelopment;
  • age-dependent weakening of levator muscle;
  • neurological disease leading to a full or partial paralysis of oculomotoric nerve or muschles

In the last case the development of ptosis of the upper eyelid due to the neurological disease is considered to have an acquired character. The pathology can also develop due to multiple sclerosis, stroke, Horner’s syndrome, encephalitis and other diseases. Deformation of the eyelid may occur after eye trauma.

Underdevelopment of the innervating muscle may be often congenital due to complications during pregnancy, birth complications as well as congenital genetic diseases.

Treatment of ptosis of the eyelid

Methods of treatment of ptosis are selected by the specialist in each individual case taking into account all characteristics of the disease.

In the most cases surgical operation is recommended to get rid of the existing defect. The operation on ptosis is conducted after the child becomes 3-4 years old: when the eyelid covers 2/3 of the pupil (incomplete ptosis) or 1/3 of the pupil (partial ptosis). If the pathology severely affects the visual function the doctor can decide to make operation before the patient reaches the age of 3-4 years.

Preventive care against upper eyelid ptosis in children.

It is recommended to do the following to avoid the development of acquired ptosis in children:

  • avoid injuries of head and eyes;
  • maintain sleep and recreation schedule;
  • eat healthy;
  • do sports regularly.

Please avoid any self-medication in case of any neurological disease that could lead to the development of ptosis.

Prevention of ptosis

Women shall be especially careful during the pregnancy, because congenital ptosis can develop as a result of birth trauma. If you have any relatives who have or had this disease we highly recommend you to examine the newborn baby by ophthalmologist.

Complications at the upper lid ptosis

If patient receives no proper and prompt therapy the vision can be impaired, which leads to strabismus, amblyopia or astigmatism. In separate cases patients experience inflammation of conjunctiva and cornea. The child may complain of dryness and irritation in the eye due to its incomplete closure.

The more apparent are the symptoms, the more often the patient tends to throw back head to increase the visual field. Such posture may lead to the development of a specific visual expression: frown, high brows and head thrown back.

Complications

We kindly recommend you to contact doctor in case of any symptoms of ptosis.

Self-medication is strictly prohibited because it can lead to many complications, including strabismus.

Only professional ophthalmologist can define the reasons leading to the development of pathology and prescribe proper treatment.

Surgeons

Игорь Эрикович Азнаурян

Igor Erikovich Aznauryan

Doctor of Medical Sciences, Academician of the Russian Academy of Medical and Technical Sciences, pediatric ophthalmologist, ophthalmic surgeon, strabismologist, refractive surgeon, founder of the Association of Pediatric Ophthalmology Clinics “Yasniy Vzor”, director of the Center for Advanced Training of Ophthalmologists

Виктория Олеговна Баласанян

Viktoriya Olegovna Balasanyan

Deputy Head of Research and Clinical Activities at Yasny Vzor pediatric eye clinics, Head of the surgery department, Deputy Head of the clinic in Solntsevo

Surgeons

Игорь Эрикович Азнаурян

Igor Erikovich Aznauryan

Doctor of Medical Sciences, Academician of the Russian Academy of Medical and Technical Sciences, pediatric ophthalmologist, ophthalmic surgeon, strabismologist, refractive surgeon, founder of the Association of Pediatric Ophthalmology Clinics “Yasniy Vzor”, director of the Center for Advanced Training of Ophthalmologists

Виктория Олеговна Баласанян

Viktoriya Olegovna Balasanyan

Deputy Head of Research and Clinical Activities at Yasny Vzor pediatric eye clinics, Head of the surgery department, Deputy Head of the clinic in Solntsevo


Best regards, the team of Yasny Vzor pediatric eye clinics