Clinical Services

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  • Ptosis

    Ptosis is an abnormally low position of the eyelid which may obstruct or limit vision from the upper part of the visual field. Ptosis results from an an abnormality or weakness in the two muscles that elevate or open the upper eyelid. Our oculoplastic surgeon can differentiate between true ptosis and excess overhanging skin “dermatochalasis," as well as determining the cause and type of ptosis.

    The most common form of ptosis is referred to as “involutional” ptosis and is caused by loosening or slippage of the Levator muscle in the eyelid. The muscle still functions normally but has “slipped” and needs to be tightened through surgery to restore a normal position to the eyelid. This is often done with an upper eyelid blepharoplasty (removal of excess eyelid skin). Frequently your insurance company will cover this procedure depending on its severity or if the vision is affected by the ptosis.

    Congenital ptosis is often identified early in childhood and is the result of an abnormal development of the Levator muscle. The muscle has not “slipped,” but it is weak and unable to fully open the eyelid. Congenital ptosis is frequently found on only one side but may also be present on both sides.

    Children with congenital ptosis should be evaluated urgently to prevent the development of amblyopia (poor development of eyesight). Surgery should be performed to correct the ptosis if the vision becomes affected, if the patient has an abnormal head posture, or for cosmetic reasons.

    There are other causes of ptosis, including trauma, tumors, inflammatory disorders, neurologic disorders and generalized muscle disorders. Some of these may be potentially lethal and patients should seek urgent evaluation in cases of ptosis that are unilateral, developed quickly or are associated with other symptoms.

    There are three main surgeries for the correction of ptosis. Depending on the severity and type of ptosis you have and the amount of extra skin on the upper eyelid, surgery can be performed through an incision in the upper eyelid crease or internally from an incision behind the eyelid (no scar). In cases of congenital ptosis, a “frontalis sling” procedure is often performed in which a silicone thread is passed from the eyebrow to the eyelid.

    At your office visit, our oculoplastic surgeon will discuss the etiology of the problem and the most appropriate surgery for you.