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Upper eyelid ptosis in adults

Ptosis is a kind of drooping upper eyelid, and that is a medical return for drooping of the upper eyelids. It is a condition that can affect one or both eyes. If it is present since birth, it is called congenital ptosis. However, droopy eyelids occur with age and to varying amounts. It is very common in adults. With ptosis, the edge of the upper eyelid, which is called the eyelid margin, falls from its normal position.

It can also change the top eyelid contour and appearance. The skin crease on the upper eyelid can look higher, and there can be more upper eyelid show. If the edge of the upper eyelid falls too low and starts to cover part of the pupil, it can block out part of the vision and affect the ability to read and to drive. It is not uncommon for a person to develop a ptosis if they have had a swelling or inflammation in their eyelid from previous intraocular surgery from trauma, from cellulitis, from recurrent chalazion and very slight chronic inflammation and swelling from the long-term wearing of contact lenses.

Oculoplastic surgeons conduct ptosis surgery. They get training in the breathtaking delicate anatomy of the upper eyelid. In particular oculoplastic surgeons are well trained and qualified to assess patients with ptosis. The assessment of ptosis involves a consultation at which a careful history is taken about the upper eyelid when the doctor will ask you the following questions:

  1. When did you first notice the ptosis?
  2. Does it run in your family?
  3. Do you see it in both eyes?
  4. How does your drooping upper lid affect your vision?
  5. Have you had any surgery before?
  6. Have you suffered from any neurological disorder or have any other medical illnesses?
  7. Does the droopiness of your upper lid vary during the day?
  8. Has the appearance of your eyelid changed?

The medical causes of a drooping upper eyelid or ptosis include it being a fundamental problem that has been present since birth where the muscle has not formed properly and is quite fatty and weak. Sometimes there is a myopathy of the muscle where it does not work as well and get quickly gets tired such as in myasthenia gravis or myotonic dystrophy. There can be nerve damage to the eyelid from trauma or another medical condition causing the upper eyelid droop. By far the most common cause however of a drooping upper eyelid or ptosis in adults is wear and tear and age. Wear and tear come from wearing contact lenses, chronic inflammation in the eyelids, recurrent chalazia, incision and curettage of chalazia, or atopy allergic eye disease with intermittent swelling of the eyelids. Often there is a genetic predisposition for ptosis and asking the person whether it runs in their family is important. They may notice that they are beginning to look like their parents did as they got older as the little thin aponeurosis thins even further and the eyelid droops.


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