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When the muscles that raise the upper eyelid are weakened or paralyzed, this condition, known as ptosis, causes the eyelid to droop. This can affect both general and peripheral vision, making it difficult to drive, read and perform other activities. If left untreated, the droopiness can cause conditions such as astigmatism (blurred vision or excessive squinting) and amblyopia (lazy eye). Ptosis is more commonly seen in the elderly when eyelid muscles begin deteriorating; however, children who suffer from this disorder need to be treated at a young age to avoid the possibility of permanent vision impairment. Causes of ptosis can include nerve abnormalities, trauma, infections, hereditary or congenital disorders. In some cases, wearing contacts for long periods can cause chronic inflammation, which may affect the development of ptosis. The effects of aging can cause mild ptosis.
Ptosis can be repaired in multiple ways, depending on the severity of the droop, whether one or both eyes are affected and depending on the strength of your lifting muscles. The goal of surgery is to tighten the natural lifting muscles. In the event that the lifting muscles are too weak, they can be bypassed with artificial material. The incision can either be through the skin (external ptosis repair) or through the inside surface of the eyelid (internal ptosis repair). If the eyelid also has excessive skin, a blepharoplasty may also be needed. These surgeries are done with local anesthesia and a light IV sedation. Moderate bruising and swelling are normal and are typically gone within 2 weeks. The scar (if present) usually blends in nicely with the upper eyelid crease.