What are the causes of Ptosis?
In adults, the majority of ptosis cases are a result of age-related changes. However, ptosis may also occur as a result of trauma, muscular, or neurological disease. As we age, the muscle that normally lifts the upper eyelid stretches and separates from the supporting eyelid plate. Since the muscle that lifts the eyelid usually has normal strength, surgical correction of a drooping upper eyelid involves repairing the stretched tendon to lift the drooping or ptotic lid. If there is muscular weakness, then the muscle itself must be repaired in addition to reattaching the tendon.

It is not uncommon to develop a droopy upper eyelid following cataract or other eye surgery, which is thought to cause further stretching of the tendon in the upper eyelid.

Ptosis is also seen in long-term contact lens wearers, specifically hard lenses. Ptosis resulting from contacts occurs at an earlier age, sometimes in young adulthood, and again is thought to mechanically stretch the tendon in the upper eyelid.

Non-age related ptosis can be caused by nerve injury to the nerve that stimulates upper eyelid “lifting” muscle
(levator muscle), or the tendon that connects it to the eyelid or certain neurological diseases.

What are the symptoms of Ptosis?
Patients with ptosis commonly complain of their eyes “feeling tired”, difficulty keeping their eyes open, eyestrain, brow ache, and difficulty reading. In severe cases of ptosis, people are seen using a finger to manually elevate the drooping eyelid, or tilting the head backwards to “peek” under the drooping lids.

Treatment of Ptosis
Ptosis is corrected surgically unless there is an underlying neurological disorder present, which is investigated prior to surgery. The goal of ptosis surgery is to elevate the upper eyelid to a more normal lid height allowing full field of vision, and symmetry with the other upper eyelid. Ptosis surgery in adults and older children is usually performed as an outpatient procedure under local anesthesia. In young children and infants, general anesthesia is administered, with the patient asleep during the surgery. In most situations the child still goes home the same day.