A healthy eyelid is the eyelid that covers 1mm of the pupil. The ptosis is defined as the more than 1mm coverage of eyelid to the pupil. The most common form of eyelid diseases is ’ptosis’.
Surgical treatment is the only treatment for ptosis, which can occur for many reasons such as congenital, aging or trauma. Congenital ptosis occurs due to the inability to develop of the muscle that lifts the eyelid, the acquired ptosis occurs due to weakening of this muscle due to aging or it may occur as a result of damage to nerves that move these muscles or some muscle diseases.
The person often suffers from peripheral vision loss and may desire to physically lift the eyelids with his fingers or forehead muscles. For this reason, they can try to see by pushing his/her chin forward or his head back.
If children have ptosis, they should be treated as early as possible, if ptosis didn’t treat in time it might lead to lazy eye disease (amblyopia). Because low eyelids do not improve or treat with the development of the child. Therefore, the physical changes in the eyelids of a child in the preschool period also affect the psychology of the child.
When should surgical treatment of low eyelid(ptosis) be planned?
There is no age limitation in this surgery. Unilateral congenital low eyelid which cover the pupil should be treated immediately. Because this condition is the cause of lazy eye and functional blindness for the eye with low eyelid and requires urgent surgical treatment. the congenital low eyelid that does not cover the pupil can be treated when the child becomes aware of this condition and there is no need to be treated immediately because it has no risk of lazy eye. Low eyelid causes social, psychological problems and introversion in children. Therefore, it is appropriate to perform surgery on these children at the age of 4 years. Low eyelid become a cosmetic problem rather than health problem in adulthood.
Beside of that, low eyelid coverage that covers the eye and pupil can cause unilateral or bilateral constriction in the peripheral vision, loss of 3-dimensional vision and functional vision loss. For this reason, the surgical operation can improve and treat the cosmetic and functional complaints and problems of the patient.
Neurological ptosis: this kind of ptosis occur due to the fact that the muscle that opens the eyelid which is the levator muscle does not move at all. In this case, there is no movement in the eyelid, maybe the entire eye may be closed. Here, operations such shortening the levator muscle, etc. are not performed. We perform methods help in opening the eyelid.
This method uses other auxiliary muscles to open the closed eyelid. For example, it will be possible to open and close the eyelid with eyebrow movements using the muscle that moves the eyebrow. The appropriate method for the person will be decided during the medical examinations before surgery.
The other method is applied when the ptosis occurs due to aging, trauma or the congenital excess length of the muscle. The interventions to be performed here are aimed at shortening the length of the muscle. Preoperative measurements of the length of the muscle are used to decide how much the muscle will be shortened.
The operation is performed with which anesthesia?
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.
How Many Days Should I Rest After Surgery? Does the eye also remain a trace?
Follow-ups is usually required on the 1st and 5th day postoperatively. In the case of ptosis surgery, the formed scar is on the outside of the eye, and since the incisions are made from the curl structure of the eyelid, Therefore, the recovery period will be fast and no abnormal scar will be shown. Since the stitches are dissolvable stitches, they do not need to be removed, they dissolve over time. In the first few days after surgery, swelling, bruising and blurred or double vision may occur. These are temporary. The patient usually returns to work within 10 days.
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:
- Family history of ptosis
- Birth injury
- Eye surgery such as cataract removal
- Paralysis of nerve fibers in eyelids
- Horner’s syndrome
- Head or eyelid trauma
- Brain tumor
- Muscular dystrophy
- Myasthenia gravis
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.