Eyelid Ptosis in adults
Eyelid ptosis in adults is usually a result of ageing changes that affect the muscles that are designed to lift the upper eyelid. Eyelid ptosis can also occur in younger adult patients, especially those who wear contact lenses, due to a continuous micro trauma from insertion and removal of the lenses.
In rare cases, eyelid ptosis can be related to a neuromuscular disease. Eyelid ptosis can also occur with the use of some drugs, following eyelid trauma or with the extra weight of an eyelid lump such as a large chalazion or tumour.
Eyelid Ptosis in children
The cause of congenital ptosis in children is different to adults. In adult ptosis the levator muscle thins at eyelid level (levator aponeurosis) whereas, in children, the actual levator muscle is replaced by fatty tissue and is short and ineffective. We, therefore, use different operations for children in which a strip of the fatty levator muscle is removed and the remaining muscle reattached to the tarsal plate. In some children, a brow suspension using a thread of suspension material between the eyelid and the forehead is used. This joins the weak eyelid to the frontalis muscle in the forehead so that when the brow is raised, the eyelid is as well (know as a frontalis suspension). This can be done with tissue from the child’s leg (fascia) or a synthetic suture.