Ophthalmology

Droopy eyelid or ptosis surgery

What does the treatment involve?

Ptosis (droopy eyelids) is always treated with surgery. When and how to operate will depend on the causing aetiology, the severity of the affection and age of the patient.

When is this treatment indicated?

In terms of treatment, ptoses are classified into those that cause visual alteration and those that do not. In the first case, it is a surgery necessary to conserve the eyesight. In the second case, treatment is for patients who consult a specialist seeking a better appearance.

Aside from that, we have the case of small children with significant congenital ptosis, as the risk of amblyopia must be evaluated at a very early stage. 

Children in whom ptosis is found to be the cause of the development of visual impairment must be operated on early and immediately, as soon as possible to avoid permanent visual issues in the future. It is, perhaps, the only case of ptosis where early surgery is essential.

How is it performed?

The different surgical techniques for palpebral ptosis are based on the status of the levator muscle function. If the condition of the levator muscle is good even though it creates drooping, the techniques will focus on strengthening it and the objectives can be reached in a more natural, predictable and simple way. 

These procedures involve manipulating and strengthening the aponeurosis of the muscle. They are simple, predictable procedures with an excellent prognosis. 

If the function is very poor, the surgery cannot be aimed at strenghthening it, which is why treatment will involve addressing the function of that muscle with substitution techniques, mainly based on the frontal muscle.

In patients who respond to stimulation of the drooping eye using Phenylephrine at 10%, surgery may be performed in a more straightforward and predictable way and even without having to make any incisions in the eyelid skin.

Results

Eyelid ptosis surgery is very safe and predictable in the majority of occasions. Except in the case of children, it is performed under local anaesthesia, so that the patient cooperates during the procedure, and the result is as exact and predictable as possible.

Possible risks

It is a very regulated and predictable surgical procedure. The most common risk is some uncomfortable bruising for the first few days, which disappears quickly. In some cases, the eyelid level reached is not the desired level, therefore, subsequent correction should be assessed.

Professionals who perform this treatment

Frequently asked questions

  • The fact that ptosis may have different causes means that there are diverse techniques for its correction. It is the specialist's job to recommend the best option to each patient in their specific case. For that reason, we do not recommend that patients rely on the comments of friends and family regarding their own experiences on the subject, since each case is different and must be treated in an individual way.

  • When the ptosis is bilateral, an attempt is made to attain maximum symmetry when correcting it. In the majority of cases it is attained, but we must remember that even people without ptosis or eyelid pathologies do not have absolutely exactly symmetrical eyes. 

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