Ptosis or “droopy eye” is a condition primarily caused by weakness in the muscles and nerves that control the upper and lower eyelid. Due to damage or an abnormal congenital development, these nerves may not communicate effectively or the muscles may not function properly. As a result of this functional mishap, the body is unable to control the eyelid causing it to sag.
Excess skin or dermatochalasis in the upper or lower eyelids can also cause ptosis, because the muscles and nerves are not meant to handle the extra weight of the excess skin.
While it may occur in either the upper or lower eyelid, it is when ptosis causes the upper eyelid to droop that it obscures and compromises vision.
Ptosis may arise due to an irregularity in fetal development, a disease or accident which damages the nerves and muscles or loosens the skin of the eyelids. Such diseases include diabetes, the Horner Syndrome, Myasthenia Gravis, as well as neuromuscular disorders and cancers. Ptosis can also be caused by less serious risk factors such as aging and contact lens wear. In addition, certain patients may have ptosis from birth or as a side effect of trauma to the eye.
While ptosis may lead to a decreased visual field and brow aches, it is mainly a cosmetic concern for adults. Children, on the other hand, need immediate treatment for ptosis because it impairs their development of healthy eyesight. Failure to treat ptosis in young children leads to amblyopia, a condition which causes a lifetime of bad vision.
The surgical removal of eyelid skin is the sole treatment of ptosis. The extensiveness of the surgical alteration depends on how much excess skin and loss of muscle control there is over the eyelid. Patients with a severe excess of eyelid skin or poor eyelid muscle control will have more skin removed than those with less excess skin and more muscle control. Please consult with your doctor for more information on the surgical treatment of ptosis.