In this section
say it: 'toe-sis'
Ptosis is a drooping of the upper eyelid. The
lid may droop only slightly, or it may cover the pupil or
eye entirely. In some cases, ptosis can restrict and even
block normal vision. It is usually treated with surgery. Ptosis
Ptosis is also known as 'drooping eyelid'. It
is caused by weakness of the muscles responsible for raising the
eyelid, damage to the nerves which control those muscles,
or loose skin of the upper eyelids.
In the more serious cases of ptosis, the lids
may droop or sag so much that they actually block a person's
Ptosis or drooping eyelid can be caused by a
congenital abnormality (present before birth), or an injury or
disease. Ptosis, which is present at birth, is called congenital
ptosis. If a child is born with moderate to severe ptosis,
treatment is necessary to allow for normal vision development. If
it is not corrected, a condition called amblyopia (lazy eye) may
develop. Amblyopia is poor vision in an eye that did not develop
normal sight during early childhood. If left untreated, amblyopia
can lead to poor vision permanently.
Although it is usually an isolated problem, a
child born with ptosis may also have:
Congenital ptosis usually does not improve with time.
The most obvious sign of ptosis in children is
the drooping lid itself. Children with ptosis often tip their heads
back into a chin-up position to see underneath their eyelids, or
they may raise their eyebrows in an attempt to lift up the lids.
Over many years, abnormal head positions may cause deformities in
the head and neck.
In most cases, the treatment for childhood ptosis is surgery,
although there are a few rare disorders which can be corrected
with medications. The eye doctor (opthamologist) will assess your
child and determine whether or not an operation
(surgery) is needed, based on:
During surgery, the levators (muscles which lift the
eyelid), are tightened. In severe ptosis, when the levator is
extremely weak, the lid can be attached or suspended from under the
eyebrow so that the forehead muscles can do the lifting. Lubricant
drops and ointment can be helpful during this period.
Surgical repair is usually very successful in restoring the
appearance and function of the eyelid, although the eyelids may not
appear perfectly symmetrical. In rare cases, full eyelid movement
does not return. In some cases, more than one operation may be
Developed by the RCH Dept of Quality and
Improvement and Dept of Opthalmology. First published in August