Ptosis (Droopy Eyelid)

Ptosis of the eyelids is a process in which the eyelids droop below the ideal position for best peripheral vision. Ptosis of the eyelids can be brought about by a Variety of causes Including developmental abnormality, aging, trauma and other medical conditions.

Risk Factors

Risk factors include aging, previous contact lens wear, and frequent eye rubbing. Several patients, anecdotally, Report that ptosis runs in their family.

Symptoms

Many individuals do not have noticeable or alarming symptoms, unless Drooping of the eyelid occurs rapidly as would occur in some concerning medical conditions. Others notice an improvement in visual quality by raising their eyelids with the muscles of their forehead or with their fingers.

Treatment

To improve the position of the eyelids a thorough examination needs to be performed in order to find the underlying cause of ptosis. After the underlying cause is determined, A treatment plan can be recommended. This plan may include conservative management or possible surgery to help improve vision.

The most common malpositions of the lower eyelid include ectropion (outward rotation) and entropion (inward rotation).

Risk Factors

Abnormal positioning of the lower eyelids most commonly occurs due to the aging process. With aging comes increased laxity of the eyelid which allows it to turn away from the eye, or inward causing the lashes to be directed towards the eye. Other risk factors include stroke, trauma, post-operative scarring, or other types scarring changes to the skin or mucous membranes of the eyelids.

Symptoms

Depending on the position of the eyelids one could experience a variety of symptoms. In the case of entropion, the eyelashes are turned towards the eye which causes a dramatic foreign body sensation. With ectropion the eye may feel dry and scratchy and produce excess tears and mucus. With either abnormal position the eye can become red.

Treatment

Conservative management includes lubrication of the eye with artificial tears or ointments which improve comfort. If the eyelid is rolled inwards, tape can be used to pull the eyelid away from the eye. Definitive treatment includes surgical tightening and re-positioning of the eyelid.

Yes, eyelid skin can be tightened through various methods. Blepharoplasty, a common surgical procedure, removes excess skin and fat, improving eyelid appearance. Non-surgical options include laser resurfacing and radiofrequency treatments, which stimulate collagen production for skin tightening. Ultherapy uses ultrasound energy to lift and tighten the skin, while injectables like Botox and fillers can temporarily smooth wrinkles and firm the skin around the eyes. The best approach depends on individual needs and preferences.

Eyelid Neoplasms

There are several types of eyelid neoplasms, or growths of the skin of the eyelid. These neoplasms range in severity from benign to cancerous lesions. Concerning neoplasms of the eyelids should be evaluated early to avoid progression of potential harmful lesions.

Eyelid Neoplasms

There are several types of eyelid neoplasms, or growths of the skin of the eyelid. These neoplasms range in severity from benign to cancerous lesions. Concerning neoplasms of the eyelids should be evaluated early to avoid progression of potential harmful lesions.

Risk Factors

Risk factors for cancerous lesions of the eyelid include increasing age, sun exposure, previous cancers of the skin elsewhere on the body, and family history of skin cancer.

Symptoms

Initially, there are very few symptoms to new growths of the skin of the eyelids. Sometimes bumps can be painful and are caused by underlying localized inflammation. Other neoplasms are painless and can be either benign or cancerous. Concerning signs of cancer include ulceration or spontaneous bleeding, hair or eyelash loss around the lesion, abnormal coloration, and fine blood vessels that are integrated in the lesion.

Treatment

The treatment for eyelid neoplasms depends on the features of the lesion. Smaller lesions without concerning features may be observed by your doctor with scheduled follow up visits to ensure stability of the growth. Inflammatory growths of the eyelid can be treated successfully with prescribed medications. Other lesions that are bothersome or have concerning features may require biopsy or excision for definitive treatment.

Ptosis is the drooping of the upper eyelid and can be congenital (present at birth) or acquired later in life. Acquired ptosis can result from aging, neurological conditions, muscle diseases, physical factors like swelling or tumors, or trauma. There's also pseudoptosis, where the eyelid appears drooped due to factors like excessive skin or a drooping brow, and neurotoxic ptosis, which can occur from exposure to neurotoxins like Botox. Each type has different causes and treatment approaches.

The best treatment for ptosis depends on the underlying cause, severity, and impact on vision. Common treatment options include:

‍Surgery: The most common and effective treatment, especially for moderate to severe ptosis. Procedures like levator resection or frontalis sling surgery aim to tighten or support the eyelid muscles.

‍Medications: In cases of neurogenic or myogenic ptosis, treating the underlying condition (e.g., using medications for myasthenia gravis) may improve ptosis.

‍Non-Surgical Options: For mild ptosis or when surgery isn't suitable, non-surgical treatments like special ptosis crutches (eyeglass attachments) can help lift the eyelid.

‍Botox: In some cases, Botox injections can temporarily address mild ptosis by weakening the opposing muscles.

Schedule a consultation with one of our ophthalmologists or oculoplastic surgeons to determine the most appropriate treatment.

Ptosis, or drooping of the upper eyelid, can be caused by various factors, including congenital issues with muscle development, aging-related weakening of the levator muscle, and neurological conditions like nerve damage or myasthenia gravis. Trauma, muscle diseases, mechanical factors like tumors or swelling, and exposure to neurotoxins like Botox can also lead to ptosis. Each cause requires different treatment approaches, often focusing on addressing the underlying condition.