The choice of ptosis treatment will depend on the cause of the ptosis, the severity of the ptosis and the remaining levator function (how much the lid can move up and down). Acquired aponeurotic ptosis with poor levator function can be treated by a frontalis sling, which attaches the tarsal plate of the lid to the eyebrow (frontalis) muscles, by means of silicone rods, so the eye can be opened by raising the eyebrow.
The majority of patients have acquired aponeurotic ptosis with good levator function and can be treated by a levator aponeurosis advancement, which reattaches the aponeurosis back onto the tarsal plate of the lid.
Surgery is carried out as a daycase procedure under local anaesthetic, so that the lid height can be checked part way through the operation, with the patient in a sitting position. This allows more accurate lid height adjustment. Consultant ophthalmic anaesthetists can also provide sedation if required.