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Droopy Eyelid (Ptosis)

Ptosis is a condition in which the eyelids droop and get in the way of vision.

What is Droopy Eyelid (Ptosis)?

With ptosis the eyelid cannot be opened fully and the pupils can be partially covered, obstructing vision. To compensate, some people may strain to tilt their head back, or lift their eyebrows, as much as possible to keep their eyes open. This can cause neck discomfort and headaches. One or both eyes may be affected. Often people find it especially difficult to keep their eyes open at night when they are tired.

Causes

Ptosis can be present from birth, Congenital Ptosis, as a result of the muscle that lifts the lid not developing properly. Occasionally ptosis can be inherited from family members with the condition. Causes of the, more common, Acquired Adult Ptosis can be divided into 5 categories:

Aponeurotic:

The levator muscle which lifts the lid is attached to the lid by a sheet of tissue, called the aponeurosis, which can be damaged by natural ageing, contact lens use or persistent eye rubbing.

Neurogenic:

The oculomotor nerve and the sympathetic nerves that control the eyelid muscles can be affected by various conditions including third nerve palsy and Horner’s Syndrome.

Myogenic:

The levator muscle can be weakened by systemic conditions such as myotonic dystrophy, muscular dystrophy, myaesthenia and chronic progressive external ophthalmoplegia.

Mechanical:

The lid can be too heavy for the levator muscle to lift as a result of blepharochalasis, orbital fat prolapse or eyelid tumours.

Traumatic:

Trauma to the eyelid can cause disinsertion, damage or scarring of the levator and its aponeurosis.

Symptoms

You may struggle to keep your eyes open, particularly towards the end of the day. Symptoms that can be associated with ptosis include:

Decreased or impaired vision, as the upper lid droops over the pupil

You may find you have to use a finger to lift the lid in order to see

Your eyes may appear half-closed in photographs

Tiredness or achiness around your eyes

Excessive rubbing of the eyes

Increased tearing

Treatments

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).

Ptosis can be mild (1-2mm), moderate (3-4mm) or severe (>4mm). The levator function can be good (>8mm), fair (5-7mm) or poor (0-4mm).

Acquired aponeurotic ptosis with good levator function can be treated by a levator aponeurosis advancement, which reattaches the aponeurosis back onto the tarsal plate of the lid.

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.

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Anis FinnAnis Finn
09:35 29 Mar 23
Beautiful clinic, really nice atmosphere, prompt service and really friendly and professional staff. Fernando was particularly great!I would definitely recommend.
Mrs TigerMrs Tiger
17:51 17 Jan 23
Excellent care, all staff very courteous and helpful. YAG surgery clearly explained to me by Mr Morgan, who did a brilliant job. I'd highly recommend this clinic.
Arya DaniArya Dani
14:43 22 Dec 22
Good location
Audrey GilesAudrey Giles
08:58 23 Nov 22
I visited the My Hearing Clinic knowing I needed a hearing assessment but thinking it was just a build up of wax. It came as a shock that I heard a hearing loss which needed addressing. The service I received from Andrew was outstanding! He explained my hearing loss and went through all my options. He recognised that it was a lot of information to take in so made a follow up appointment, giving me sufficient time to think about what I wanted to do. From start to finish the service has been excellent, efficient, professional and friendly from the moment you walk through the door and meet Lee. The clinic is well located, parking on site, high standard of cleanliness. Definitely a recommendation from me. Thank you!
Andrea BoothAndrea Booth
19:55 22 Nov 22
Absolutely first class treatment and experience at this wonderful clinic. Staff were exceptionally welcoming and friendly Mr Morgan the consultant was lovely explaining everything. I had YAG laser treatment painless no discomfort and almost immediate corrected vision. Thank you all so very very much.
Glynis GallagherGlynis Gallagher
16:41 17 Nov 21
Visited clinic today with a totally blocked left ear. Had micro suction to remove a huge build up of ear wax. It was over in minutes. Excellent, efficient and friendly service from start to finish. Would recommend 100% Worth every penny!
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