What is it?
Ptosis is the lowering of the upper eyelid from its normal position, which is about 1 mm below the upper limbus line (upper margin between the colored and white portions of the eye). The lower eyelids may also be impacted where the normal positioning is by touching.
Causes and risk factors
The most common forms of ptosis are those that occur with aging (acquired ptosis - senile) or those existing from birth (congenital ptosis). More rarely we find the forms of ptosis of neuropathic origin and sometimes those of mechanical origin resulting from the weight of benign or malignant skin neoformations that gravitate on the eyelid opening.
Which are the symptoms?
The senile form (which is the most frequent), is caused by an elongation of the most distal part of the elevator muscle (aponeurosis) or even by its disconnection from the tarsal plane.
- Reduction of the visual field
- Contraction of the frontal muscle
- Eyebrow asymmetry
- Head hyperextension
- Worsening in the evening
How is it diagnosed?
Clinically based on descent eyelid, varying degrees up to severe descent with pupil coverage.
How is it treated?
In the senile form, two main surgical interventions can be performed, namely plication of the eyelid elevator muscle or repositioning of the muscle on its tarsal insertion. The surgical treatment varies for congenital forms according to the age of the child, the degree of ptosis and the reactive functioning of the elevator muscle of the upper eyelid (muscle that has the task of raising the eyelid for the opening of the eye).
Where do we treat it?
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