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What We Treat > ChildrenWhat is a droopy eyelid or ptosis?A droopy eyelid or ptosis can be present at the time of birth (congenital) or occur later in life (acquired). Congenital ptosis is usually caused by abnormal function of the levator palpebris muscle in the upper eyelid. Acquired ptosis has many possible causes. Ptosis can involve one or both upper eyelids. What problems can occur as a result of childhood ptosis? Vision problems that can be caused by ptosis in childhood include astigmatism and amblyopia. Other problems include chin up head positioning to see below the droopy eyelid and use of the occipito-frontalis muscle (in the forehead) to help elevate the eyelid. What causes acquired ptosis? Acquired ptosis can be caused by neurological conditions that affect the nerves or muscles of the eye. These include myasthenia gravis, progressive external ophthalmoplegia, Horners syndrome and third nerve paralysis. The ptosis may be combined with an eye movement disorder that could cause double vision. A mass in the eyelid can also cause the eyelid to droop. How is ptosis evaluated by the ophthalmologist? The doctor attempts to determine when the ptosis started, whether it is variable or constant, whether it changes with tiredness and if the patient has double vision. This helps the doctor determine what caused the ptosis. The eyelid position is measured, vision assessed and the head position observed. A complete eye examination including a glasses check is done. How is ptosis treated? If amblyopia is present appropriate treatment is initiated. When potential amblyopia causing astigmatism is present, spectacles are often prescribed. Early surgery is usually indicated if the droopy eyelid blocks vision (which may cause delayed vision development) or causes a child to use a chin up head position (which may cause neck problems and/or delay of developmental skills). Children are usually observed on a regular basis to ensure no visual problems develop. During preschool years surgery may be indicated for social reasons. Source: www.aapos.org/ |
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