Ptosis is the drooping of the upper eyelid. Although ptosis is usually the result of aging, it sometimes develops after eye surgery or injury. Sometimes the condition is congenital. Because ptosis may be present due to serious causes, patients with this disorder should be checked by a medical professional to determine whether treatment is necessary and, if so, what kind.
Causes of Ptosis
Typically, ptosis results from a weakening in the muscle responsible for raising the eyelid, or from damage to the nerves that control the muscle. In some cases, ptosis is simply caused by loose skin on the upper eyelid. Sometimes, however, the reason for ptosis is more troubling. In addition to the possibility of its being congenital, or the result of injury or surgery, ptosis may be caused by the following:
Migraine headache
Eyelid growth (such as a stye)
Bell’s palsy
In rare instances, ptosis can be caused by a brain tumor that affects the reactions of muscles or nerves.
Myasthenia gravis
Horner syndrome
Benign or malignant tumor
Symptoms of Ptosis
In addition to the drooping of one or both eyelids, symptoms of ptosis include the following:
Increased tear production
Difficulty blinking or closing the eye
Reduced vision (with severe drooping)
Since ptosis caused by aging is usually gradual, a sudden onset of symptoms is greater cause for concern.
Diagnosis of Ptosis
Ptosis is typically diagnosed by an ophthalmologist, who can also frequently determine its cause. The ophthalmologist tests for visual acuity, and may perform a visual-field test, a slit-lamp examination and, possibly, a tension test. If there is a suspicion of an underlying systemic disease, the patient will be referred to an internist or other physician for further evaluation.
Treatment of Ptosis
Patients may seek treatment for droopy eyelids for cosmetic or medical purposes. Severe drooping obstructs vision. If ptosis interferes with a patient’s vision, a blepharoplasty is performed to eliminate the drooping. Many young patients with mild-to-moderate ptosis should be examined regularly to check for other vision problems, including amblyopia, refractive errors and muscular diseases.

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