Ptosis is a phenomenon when the upper eyelid passes over the eye. The lid can cover a small part, or so much that it covers the pupil completely. Ptosis can limit or even completely block normal vision. Both children and adults can have ptosis. Fortunately, this condition can be treated to improve vision as well as appearance.

Ptosis in children

Children born with ptosis have what is called congenital ptosis. This can be caused by problems with the muscle that lifts the eyelid (called the levator muscle). The most obvious sign of ptosis is a drooping eyelid. Another sign is when the upper folds of the eyelid are not in the same plane as the other. A child with ptosis may throw their head back, lift their chin, or raise their eyebrows to try to see better. Over time, these movements can cause head and neck problems. Sometimes, a child born with ptosis may have other eye-related problems. These can include eye movement problems, eye muscle disease, tumors (on the eyelid or elsewhere), and other problems.

Having ptosis puts a child at risk for vision problems. If the child’s eyelid is so lowered that it blocks vision, amblyopia (also called “lazy eye”) may develop. One eye will have better vision than the other. A child with ptosis may also have astigmatism, where he sees blurry images. The child may also develop a form of strabismus (crossed eyes).

Ptosis in adults

Adults have ptosis (called involutional or acquired ptosis) when the levator muscle stretches or separates from the eyelid. This can be caused by aging or injury. Sometimes ptosis occurs as a side effect after certain eye surgery. Rarely, diseases or tumors can affect the eyelid muscle, causing ptosis. Our medical team will find the cause of your ptosis in order to recommend appropriate treatment. A complete eye examination will be performed, as well as blood tests, if necessary. 

Treatment of ptosis in children

The following factors are taken into account when deciding on the best way to treat ptosis in children:

• Age of the child
• Whether one or both eyelids are involved
• Eyelid height
• Eyelid muscle strength
• Eye movements

In most cases, surgery is recommended to treat ptosis in children. If the child also has amblyopia, that condition must be treated as well. All children with ptosis – whether they have surgery or not – should see an ophthalmologist regularly for eye exams. Since children’s eyes change shape during growth, they must be regularly checked for amblyopia, refractive disorders, and other eye problems.

Ptosis surgery for adults

Ptosis surgery is usually done as an outpatient procedure, meaning you can go home the same day after surgery. The procedure is performed under local anesthesia, less often under general anesthesia. In certain cases, the doctor may only need to slightly adjust the lifting of the eyelid muscles. For more severe ptosis, the levator muscle may need to be strengthened to some extent.

As with any type of surgery, there are potential risks and complications with ptosis surgery. Before eyelid surgery, it is absolutely necessary to inform the ophthalmologist about all the medications you are using.