Instead of intervening in the muscle that opens the eyelid, a method of helping that muscle must be applied. In this method, auxiliary muscles are used to hold the eyelid upward.
For example, an attempt is made to open the eyelid by using a piece of muscle or using a fiber (with the help of silicone threads or fiber from the patient’s body). The other method is applied for extended eyelid muscles depending on congenital, trauma, or age.
If the muscle is working a little and if there is a slight movement, the problem can be solved by shortening the muscle length. Thus, the shortened muscular strength will be enough to open the eyelid.
Children born with ptosis are called congenital ptosis. This can be caused by muscle-related problems that lift the eyelid. The most obvious sign of ptosis is a drooping eyelid. Another sign is that alignment of the upper eyelid crease equal to each other. A child can bend his head backwards with ptosis, may raise eyebrows to remove the jaw or trying to see better. Over time, these movements can cause head and neck problems.
Sometimes there may be other problems observed as a child born with ptosis. Eye movement problems can include eye muscle disease, tumours (on the eyelid or elsewhere), and other problems.
Generally, ptosis occurs as a birth defect.
Although the surgical touches are planned milimetricly during the physical examination before the operation, the final decision is made during the operation by opening the patient’s eye and checking. Thus, the operation is mostly performed under local anesthesia.
However, if the patient is a child, the operation should be performed under general anesthesia. The patient should have routine controls and check up in order to determine the patient’s suitability fort he operation before any further steps. Physical examination and calculations are initial to plan the surgery.
Regardless of the reason, droopy eyelids are examined in three different categories.
General anesthesia is almost mandatory in ptosis operations in children. However, local anesthesia is preferred in adulthood.
As it prevents unnecessary administration of drugs to the body and provides protection from problems related to anesthesia, it also provides the opportunity to keep the eye open during anesthesia and to adjust the eyelid level symmetrically with the other eye.
If the patient needs muscle repairment, the patient may have some difficulty in closing the eyelid totally.
Since the eyes can not be closed totally, the patient can use eyedrops to prevent any discomfort while sleeping.
The patient may be discharged on the same day, or 1 day after the operation, if the operation is performed under general anesthesia.
Patients who underwent ptosis surgery under general anesthesia can be discharged the nest day after the operation. They do not need a bandage to cover the eyes.
Post-op controls are necessary.
The scars left after the ptosis operation can not be seen from outside easily since the incisions are made through a natural line. The recovery is fast. The patient may experience swelling, bruises and blurred vision or double vision during the first few days after the operation. It is temporary. The patient can return to work in 10 days.
An eyelid lift is a procedure that fixes the extra skin or fat around the eyes. While many people feel that they can see more after this procedure, it doesn’t address problems when the muscle that opens the eyelid is affected. In Ptosis surgery, that muscle is reattached to its natural position. During ptosis surgery, the height and contour of your eyelid can be adjusted, so that the eyelid rests in a more natural, higher position.
There are many factors may increase your risk for developing ptosis. Such as:
Droopy eyelid (ptosis) is the being of the upper eyelid below than its normal level. This can be on one side or both sides.
Depending on the level of the droopy eyelid (ptosis), in severe cases, the eyelid may close the pupil and prevent vision.
Droopy Eyelid (ptosis) is treated surgically. Muscles that hold the eyelid sag and weaken due to aging, shock and many other causes, during surgery these muscles are shortened to make them more functional. In some cases, these muscles can also be pulled up using a silicone suture, fiber or sling method.
Normal eye rubbing or itching does not cause ptosis but sometimes it’s become kind of a habit for some people, this continuous rubbing may cause ptosis.
Some people may have congenital eyelid excess or born with a small eye. This case looks like eyelid ptosis from the outside while it is not, that’s why it’s called false eyelid ptosis.
© Prof. Dr. Bekir Atik, MD. All Rights Reserved.
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