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Ptosis

Published by Bupa’s Health Information Team, August 2011.

This factsheet is for people who have ptosis, or who would like information about it.

Ptosis is a condition that affects the upper eyelid causing it to droop. People with ptosis may not be able to lift their eyelid enough to uncover the entire eye. This can affect their sight and physical appearance. It can affect one or both eyelids.

About ptosis

Ptosis is also called blepharoptosis. Ptosis is most common in older people, although you can be born with it.

In adults, ptosis usually develops when the muscle that lifts the upper lid stops working properly because its tendon has stretched. In babies, ptosis is caused by muscles in the eyelid not developing properly.

If your child is born with a drooping eyelid, or develops one before he or she is a year old, the condition is called congenital ptosis.

Ptosis varies in severity. For example, mild ptosis may cause your eyelid to droop a small amount, which can affect your appearance but not your sight. If it’s more severe, it can affect the upper part of your vision and cause tiredness.

Symptoms of ptosis

The first and most obvious symptom of ptosis is a drooping eyelid. This can make you look tired and sleepy.

You may find that you have to start tilting your head back to see properly. The way the eyelid droops may also affect the upper area of your vision. If ptosis is severe, you may need to use your finger to lift the lid to see properly.

If your child has ptosis, you may notice similar symptoms, especially tilting of the head. Your child may raise his or her eyebrow to lift the lid. The skin creases in your child’s upper eyelid may also look uneven - this may be particularly noticeable in photographs.

Complications of ptosis

In children, if ptosis isn’t treated, it can cause amblyopia (commonly known as lazy eye). This is when sight in the affected eye doesn’t develop properly in early childhood. Amblyopia can permanently affect your child’s sight if it isn’t treated. Amblyopia can be treated by blocking the vision in the ‘good’ eye, which encourages the sight to get better in the affected eye.

Ptosis affects your appearance and this can lead to emotional problems such as loss of self-esteem. This can happen for both adults and children, and in children can lead to problems at school.

In both adults and children, ptosis can affect sight, which can make it difficult to carry out everyday activities such as reading, climbing stairs or driving. For some people, this may cause headaches, usually at the front of your head.

Causes of ptosis

There are a number of different causes of ptosis, depending on whether you develop the condition (acquired) or whether you’re born with it (congenital).

Acquired ptosis is caused by a thinning of the muscles and tendons that raise your eyelid up and down. Sometimes a tendon may also become detached. This may happen for a number of reasons including:

  • your age - ptosis is more common as you get older
  • wearing contact lenses
  • cataract surgery
  • an injury to your eyelid
  • a tumour, although this is rare
  • a nerve or muscle condition

In most children the cause of congenital ptosis is unknown. The muscles and tissues in and around the eyelid don’t develop properly. Rare genetic conditions may also cause ptosis.

Diagnosis of ptosis

If your GP or optometrist (a registered health professional who examines eyes, tests sight and dispenses glasses and contact lenses) thinks you might have ptosis, he or she will refer you to a specialist called an ophthalmologist. An ophthalmologist is a doctor who specialises in eye health, including eye surgery.

The ophthalmologist will ask you about your symptoms and examine both your eyes. He or she may also ask you about your medical history and carry out tests to try to find out what is causing your eyelid to droop. You will have photographs and measurements taken of your eyelids. If your child has ptosis, he or she may also need to have their eyesight tested.

Treatment for ptosis

Ptosis doesn’t always need treating. If you or your child has mild ptosis, your doctor may not treat your condition, instead he or she may monitor it. This might mean regular eye tests, particularly for children.

Some people with ptosis who wear glasses choose to have them adapted with a special prop. This prop sits on the upper part of the frame of the glasses and lifts your eyelid, allowing you to see more easily. Ask your optometrist for information.

Surgery

Some people with ptosis need surgery to correct it. The more severe your ptosis the more likely you are to need surgery. If your child has congenital ptosis, he or she is likely to need surgery to correct it.

For adults, surgery is usually done as a day case in the outpatient department, using a local anaesthetic. If you have a local anaesthetic, you will be awake during the procedure, but you won’t feel any pain. If your child has surgery for ptosis, he or she will have a general anaesthetic. This means your child will be asleep during the procedure.

The most commonly performed operation involves making a small cut in the natural skin crease on your upper eyelid. The muscles that open your eyelid are then shortened. The small incision on your eyelid is closed using dissolvable stitches. Making the cut in line with the skin crease will help to hide any scar.

 

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.


  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

    Approved by Plain English Campaign The Information Standard memberHON Code

     

  • Publication date: August 2011

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