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Ptosis (toe-sis) is a drooping of the upper eyelid. The lid may droop only slightly, or it may cover the pupil or eye entirely. Ptosis can affect one or both eyelids. In some cases, ptosis can restrict and even block normal vision.
Sometimes ptosis is present at birth; in other cases it occurs later in life due to injury or disease.
Ptosis is usually treated with surgery.
The most obvious sign of ptosis in children is the drooping lid itself. Your child may have:
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.
If you think your child has ptosis, take them to see your GP. You will be referred to an ophthalmologist (eye doctor).
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 permanent poor vision.
The treatment for childhood ptosis is usually surgery, although there are a few rare disorders which can be corrected with medications. The ophthalmologist will assess your child and determine whether or not 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.
Ptosis is also known as drooping eyelid, and it is caused by weakness of the muscles responsible for raising the eyelid, damage to the nerves that control those muscles, or loose skin of the upper eyelids.
Ptosis can be caused by a congenital abnormality (present at birth), or it can develop later due to an injury or disease. Ptosis that is present at birth is called congenital ptosis. Although it is usually an isolated problem, a child with congenital ptosis may also have:
My child has mild ptosis. Will she grow out of it?
Mild ptosis is not often noticeable when your child is awake
and full of energy. It can become more obvious as they get tired. Not all cases
of ptosis require surgery, but you should discuss all options with your child's
Will my child's eyelid be completely normal following
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. Sometimes, more than one operation may be required.
Developed by The Royal Children's Hospital Ophthalmology department. We acknowledge the input of RCH consumers and carers.
Reviewed March 2018.
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