Ptosis is also called "drooping eyelid." It is caused by weakness of the muscle responsible for raising the eyelid, damage to the nerves that control those muscles, or looseness of the skin of the upper eyelids.
Drooping eyelid can be caused by the normal aging process, a congenital abnormality (present before birth), or the result of an injury or disease.
Risk factors include aging, diabetes, stroke, Horner syndrome, myasthenia gravis, and a brain tumor or other cancer, which can affect nerve or muscle reactions.
- A physical examination to determine the cause
- Special tests may be done to evaluate suspected causes, such as myasthenia gravis
The expected outcome depends on the cause of the ptosis. Surgery is usually very successful in restoring appearance and function.
Drooping eyelids in children require prompt evaluation by an ophthalmologist.
New or rapidly changing ptosis in adults requires prompt evaluation by an ophthalmologist.
If a drooping eyelid is left uncorrected in a child, it can lead to lazy eye.
If an underlying disease is found, the treatment will be specific to that disease. Most cases of ptosis are associated with aging and there is no disease involved.
Surgery can be done to improve the appearance of the eyelids in milder cases if the patient wants it. In more severe cases, surgery may be necessary to correct interference with vision. In children with ptosis, surgery may be necessary to prevent amblyopia.
Custer PL. Blepharoptosis. In: Yanoff M, Duker JS, Augsburger JJ, Azar DT, eds. Ophthalmology. 2nd ed. Philadelphia, PA: Mosby Elsevier; 2004: sect 2, chap 86.
Olitsky SE, Hug D, Smith LP. Abnormalities of the Lids. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th Ed. Philadelphia, PA: Saunders Elsevier; 2007: chap 623.
Review Date: 7/17/2008
Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Maternal & Child Health Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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