What is ptosis and how can you treat it?
So if you have a drooping eyelid and it is bothering you, either cosmetically or medically functionally, then you do need to see an oculoplastic surgeon like myself.
I would assess it and decide whether it is just an involutional or aging ptosis, maybe related to your contact lenses. Or whether it is a more serious underline cause. Bearing in mind, don’t get worried if you have got a ptosis, it is exceedingly common. You get more ptosis as you get older and for lot of the time people compensate by lifting their eyebrows at the same time they can lift the eyelid a little bit.
So as I said earlier it is either cosmetic or medical. The medical reasons for operating with ptosis are interfering with your vision, so your visual field is getting, the upper part of it is getting shadowed by the eyelid which is dropping. And if it is both eyelids that really significantly interfere and even get in the way of your driving safely.
So, ptosis is common, it can be assessed and treated by an oculoplastic surgeon. The surgery is done under a local anaesthetic. It is very gentle delicate surgery, it is done as a day case, here at Clinica London. You’d come in an hour before, just so you can get relaxed from traveling and you see the nurse, who would go over again what is involved with the surgery. You would have already had your information sheet from the first consultation.
We then go over the consent form together, make sure that you don’t have any further questions. If you want a little bit of light sedation you can have it. But mainly we like to do it entirely under local anaesthetic. Very good reason for this is that we can sit you up and down during the surgery. So for instance in the beginning of the surgery, you start sitting, and then I mark the skin crease and work out where we are going to move the eyelid to. And then we lie you down and we gently give the local anaesthetic, do the surgery, using delicate … and delicate instruments.
And then, because you are awake, you can look up and down and that helps me identify the muscle, that is the one that slipped a bit, or just not functioning so well and it causes the eyelid to drop. And then I can move that muscle forward, I can advance it, so that is called eyelid lifting. So I lift the eyelid to correct the ptosis or to correct the drooping eyelid.
At the end I close the skin crease, so everything is hidden in the skin creases, close up with either with very, very fine stitches or I can make it sutureless, stitch free, using fibrin adhesive. Depends on your age and various other factors and then often there will be a little light pad afterwards, that can be there for between one hour and on to the morning after.
More about Jane Olver
Ms Jane Olver is the founder of Clinica London and a Consultant Ophthalmologist and Oculoplastic Surgeon. Her special expertise is in oculoplastic and cosmetic eye surgery including eyelids and lacrimal surgery. She is specialised in endoscopic lacrimal surgery for watering eyes in adults and children. She has over 20 years’ experience in treating people with eye problems just like you, and has published extensively in scientific journals about Ophthalmology and Lacrimal Surgery and is the author of the books “Ophthalmology at a Glance” and “Colour Atlas of Lacrimal Surgery”. At Clinica London, she is responsible for the Aesthetic Medicine and Surgery part, as well as patients with eye, eyelid and tear duct problems, and acute eye problems.