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 Eyelid Surgery

 (Ptosis of upper eyelid)

The word PTOSIS is synonymous of fallen. Ptosis of the upper eyelid means that the level of the upper eyelid is under the normal parameters, and it interferes with the field of view.

It is classified depending on the moment of life in which it appears, the conditions and what causes it.  

Basically there are two classes of Ptosis of the upper eyelid:  

1.-Congenital Ptosis: It occurs when the patient is born with this pathology.

2.-Acquired Ptosis: It is when the Ptosis appears for the first time in any stage of life that is not birth. 

3.- Congenital Ptosis can affect one or both upper eyelids, and it is caused by a dystrophy of the eyelid’s elevating muscle.

 

Before

After

The Acquired Ptosis can affect one or both eyelids depending on the cause.

Among these causes we can find:

a.       Neurogenic: When there is an alteration of the  Common  Ocular Motor nerve,                  which  is the one that commands the elevating muscle.

b.       Miogenic: An alteration of the Elevator Muscle’s body occurs, as in the      Myasthenia       Gravis

c.       Aponeurotic: It’s when the Aponeurosis of the Elevating Muscle detaches partially or totally   , or it stretches, or it debilitates. This happens frequently and   mainly to adult patients, on one or both eyelids. It is related to aging or traumas. Some             say that the use of bifocal lens and contact lenses could be another probable cause of Aponeurotic Ptosis

d.     Mechanical: A tumor in the upper eyelid or an excess of eyelid skin can force the level  of the eyelid to be under the normal position. In this case the extirpation of the    tumor  or an aesthetic blepharoplasty would help this condition disappear. The treatment will    depend on the cause.

Picture 1.-. - This is a patient with an Acquired Ptosis of the upper eyelid, which has an Aponeurotic origin. The patient came to my office to have it corrected. You can observe the low level of the eyelid when looking forward.

Picture 2.- The ptosis can still be observed when patient is looking upwards.

Picture 3.- The ptosis is corrected performing a surgical plicature of the Elevator’s Aponeurosis. Looking forward

Picture 4.- The results of the surgery, patient is looking upwards.

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