Ptosis of the upper eyelid - Causes , treatment , surgery


1. Causes of ptosis

2. Symptoms

3. Diagnosis and treatment of upper eyelid ptosis

ptosis (in Greek "fall") - a disease characterized by ptosis of the upper eyelid.

This disease occurs in people of all ages.Often it is accompanied by amblyopia (reversible decrease in visual acuity) and strabismus.

upper eyelid ptosis can develop in one eye (unilateral) and two eyes at the same time (two-sided).

Depending on the severity of ptosis is:

  • part - two-thirds of the upper eyelid covered the pupil;
  • partial - upper eyelid is closed the upper third of the pupil;
  • full - upper eyelid covers the pupil completely.


Causes There are many causes of upper eyelid ptosis - congenital abnormality, different illnesses, injuries, surgeries, aging.But in most cases, ptosis develops due to a defect of the elevator muscles, which is responsible for lifting the upper eyelid.

congenital form of the disease occurs as a result of incomplete development, weakness, or thinning of the mus

cles of the elevator or pathological nerve defect, which administers this muscle.Because of this, there are disturbances due to central nervous system.This pathology is caused by genetic faults, complications during pregnancy and delivery, birth trauma.

lack of timely treatment of congenital ptosis contributes to the development of amblyopia, strabismus, anisometropia (pathology, in which the difference in eyesight of more than 3 diopters).

Causes of acquired ptosis nature are the following factors.

1.Rastyazhenie or weakening fascia (connective plate fixation muscles) of the elevator muscles.This kind of disease is called the aponeurotic and divided into senile (the result of aging) and ptosis due to surgery or trauma.

2.Deformatsiya century breaks, foreign bodies, scars - mechanical ptosis.

3.Bolezni and damage to the nervous system as a result of multiple sclerosis, stroke, or injury.This kind of disease is called neurogenic.Neurogenic ptosis often develops due to paralysis of the cervical sympathetic nerve.In this case, the upper eyelid ptosis accompanied by constriction of the pupil and the retraction of the eyeball, the so-called syndrome Horner's syndrome.

4.Izbytochnye skin folds of the upper eyelid (blepharochalasis), hypotonia (reduced IOP), ocular strabismus.This causes ptosis, which is called false or apparent.


In many cases, upper eyelid ptosis is greatly reduced or completely missing its mobility.The upper eyelid in the lowered position leads to problems with vision.Therefore, the patient gets used to the situation raised eyebrows.With a significant omission of the century, most often in children, there is a forced posture - "head of the astrologer."It is characterized by elevated position of head and wrinkled his forehead.upper eyelid ptosis of the child interferes with the normal development of the visual analyzer and leads to the development of many visual disturbances.

signs of ptosis are irritation of the eyes, double vision, fatigue due to prolonged muscle tension.In cases where it is impossible to completely close the eye, the patient has symptoms of dry eye, develop chronic keratitis (inflammation of the cornea) and conjunctivitis (inflammation of the conjunctiva of the eye).

there are additional symptoms In rare species of ptosis.As a sign of Marcus-Gunn syndrome is the disappearance of the omission of the century with the clenched jaw or opening the mouth.

Diagnosis and treatment of upper eyelid ptosis

For right choice of a method of treating ptosis, it is very important to find out is congenital or acquired disease in a patient.TBD family history of the disease and its causes.For this purpose, the patient is often necessary to consult a neurologist.

On examination by an ophthalmologist determine the following indicators:

  • position of the upper eyelid with respect to the pupil of the eye;
  • size of the skin fold on the upper eyelid;
  • force muscle responsible for lifting the upper eyelid;
  • symmetrical eye movement;
  • mobility of the eyebrows;
  • value of visual acuity;
  • value of intraocular pressure;
  • check for amblyopia, especially important indicator for children.

Successful treatment of upper eyelid ptosis significantly depends on the timely initiation of therapy.

main type of treatment is surgery.However, surgery for ptosis do not recommend children under age three years.This is due to the fact that a child under that age is not yet completed the process of forming the optic fissure and eyelids.Until that time, to prevent the development of a child for amblyopia and strabismus in the day he pulled up the upper eyelid plaster.Only you must be sure to remove the band-aid on the night.This is a temporary method that does not cure the child from ptosis.

If the ptosis caused by the presence of the neurological disease, primarily treat the underlying disease.

Surgical treatment of ptosis depends on the nature of the disease.

aim of the operation with congenital ptosis character is a shortening of the muscles of the elevator that lifts the upper eyelid.The surgeon removes the upper eyelid on a small strip of skin and muscle elevator stitches.This makes considerably shorter arm.At strongly expressed ptosis elevator muscle sutured to the frontal muscle.

Operation with acquired ptosis nature aimed at shortening the stretched muscle fascia elevator.The doctor removes a thin strip of the upper eyelid skin.This removes part of the fascia and the muscle that lifts the upper eyelid.As a result of shortening of the fascia, followed by stretching the muscle and upper eyelid raised.

Surgery is performed under local anesthesia.The process is quick and painless.

at 3-5 days after surgery sutures are removed from the eyelid skin.And a week later the man returned to normal life.

Surgical treatment of upper eyelid ptosis usually has a favorable prognosis.Typically, the disease is not resumed.


This article is available exclusively in the educational purposes and is not research material or professional medical advice.

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