Ptosis is the medical term for drooping of the upper eyelid, which may affect one or both eyes. As the edge of the upper lid falls further, the upper field of your vision may become diminished.

Causes

Ptosis may be present at birth (congenital) or appear later in life (acquired). Congenital ptosis is usually a result of improper development of the levator muscle responsible for lifting the upper lid. There are several causes of acquired ptosis. Among them, the most common cause in the stretching of the levator muscle, due to the ageing process. It is not uncommon to develop ptosis after cataract surgery which can sometimes cause the attachment of the already weakened muscle to stretch further.

Occasionally, an injury to the nerve that stimulates the levator muscle can also cause ptosis. Rarely, ptosis may be the first sign of myasthenia gravis, a condition in which body muscles tire easily.

Symptoms

You may find it more and more difficult to keep your eyes open, or you may feel eye strain and eyebrow ache from the increased effort to raise the lids, or fatigue when reading. In severe cases, it may be necessary to tilt your head backward in order to see from under the eyelid. Your family and friends might also notice that you constantly have a "tired" appearance. Children with congenital ptosis are at risk of developing "lazy eyes" or amblyopia, squints and astigmatism.

Treatment

Ptosis is treated surgically. The main goal of surgery is to elevate the upper eyelid to permit a full field of vision, and attempt to achieve symmetry when the patient is looking straight ahead. Patient with congenital ptosis will still have a drooping lid on up gaze and the white of the eye (sclera) will become visible on down gaze. There may also be inadequate lid closure during sleep.

However, when operating on an abnormal muscle, it is not possible to achieve a completely normal lid position and function after surgery. The specific operation required is based on the underlying cause of the ptosis, as well as the severity of ptosis and the strength of the levator muscle. Surgery is usually performed under local anaesthesia in adults, where a small injection is given around the upper lid to numb the area.

Ptosis or droopiness of the upper eyelids may be mild or severe. When severe, surgical correction is generally recommended. This can be easily verified by paying a visit to your eye doctor.

* This is a general guide. If in doubt, please consult your doctor.