Drooping Eyelids (Dermatochalasis & Ptosis)
Ptosis (pronounced “toe-sis”), or blepharoptosis, is the medical term for drooping of the upper eyelid. This reduction in the size of the eyelid opening may cause reduced field of vision because the eyelid crosses part, or all, of the pupil. Patients with ptosis often have difficulty opening their eyelids completely and frequently lift their eyebrows to compensate for this deficit. Ptosis is frequently asymmetric between the two eyes.
As we age, the skin of the eyelids becomes thinner and stretches resulting in excess skin (dermatochalasis). Fatty tissue around the eyes can become more prominent and more apparent through the thin tissue.These aging changes make us look tired and older than our actual age. Blepharoplasty is a simple, outpatient procedure that can restore the eyelids to a more rested and youthful appearance. Occasionally the eyelid skin can become so severe that it may block the upper field of vision, in which case the surgery can eliminate the obstruction and improve the peripheral field of vision. For more information see Dr. Joos’ Medscape article.
FAQs
What are the Causes of Ptosis?
There are several causes of ptosis including age-related stretching of the muscles, trauma, congenital (from birth) weakness, neurologic disease and others. The most common of ptosis in adults is a progressive stretching of the major eyelid muscle (levator palberae) causing the eyelid to sit lower than it should for optimal vision and function. Ptosis may also occur after routine cataract surgery, LASIK surgery or from prolonged contact lens use. Children may have ptosis from birth which can have profound negative effects on their visual development. Droopy eyelids in a child should be evaluated by a doctor as soon as possible.
How is Ptosis Corrected?
If ptosis is severe enough to block peripheral vision, your insurance may approve the procedure. If the ptosis is mild, ptosis surgery can still be performed without insurance coverage. Ptosis is corrected surgically by tightening the muscles that raise the eyelid. There are various techniques for ptosis repair, which are specialized procedures best performed by an oculoplastic surgeon. Your surgeon will perform an exam and testing to determine the best approach for correction in each individual patient. Ptosis surgery is outpatient surgery typically performed under local anesthesia with or without sedation. The goal of surgery is to elevate the eyelid to restore a full field of vision and provide symmetry of the eyelids. Ptosis surgery is often performed at the same time as other facial surgical procedures such as upper eyelid blepharoplasty to remove excess upper eyelid skin.
Surgery is performed under local anesthesia with or without sedation. Surgery generally takes around 30-60 minutes. Patient’s can typically return to work after 5 to 7 days. There will be some bruising and swelling of the eyelids for 1 to 2 weeks. There is minimal discomfort after the procedure usually relieved by over the counter medications like Tylenol. Ice packs are recommended for the first 2 days after surgery to decrease swelling. Over the counter agents such as Arnica can help reduce bruising.