Ptosis is a common condition that we see in our practice. Ptosis refers to a droopy or low-set upper eyelid. When someone has ptosis, they notice that their eyelids (one or both) are resulting in a tired-appearance. If the eyelid is droopy enough, it can even prevent the ability of the eye to see well in the peripheral vision, which can affect one’s ability to get around with their daily activities including driving.
Ptosis can occur from various conditions, the most common being associated with age. As we age, our eyelids and facial structures lose their elasticity. The eyelid muscle can weaken as well, and can result in a lower than normal position.
Other conditions that cause stretching and weakening of the eyelid muscles can also result in ptosis, such as:
- Prior eyelid or eye surgery.
- Trauma to the eyelid,
- Prior eyelid or eye infections
- Even long term use of contact lenses.
Ptosis is usually a gradual problem that occurs and worsens slowly over many years. However, children can also be born with ptosis, and this is referred to as congenital ptosis. In congenital ptosis, the eyelid muscle that usually keeps the eyelid open is weak and requires surgery if the eyelid is blocking the child’s ability to see. Children with ptosis should have an evaluation by an eye doctor specializing in children first to determine if their droopy eyelid is affecting their vision, and if it is, ptosis surgery should be performed. In cases when one develops sudden ptosis with or without other conditions (such as double vision), they should evaluated promptly by a regular doctor or eye doctor to make sure there are no other neurological problems that need to be addressed.
Evaluation for Ptosis
Patients with ptosis that wish to have it repaired should see an oculoplastic surgeon that routinely performs ptosis surgery. Dr. Zoumalan exclusively specializes in eyelid plastic surgery, and ptosis surgery is one of the most common procedures he performs.
A ptosis evaluation involves checking the eyelid position (how droopy the lid is), the strength of the muscle, brow position and whether a part of the ptosis is caused brow ptosis as well. After undergoing a thorough evaluation, Dr. Zoumalan will recommend the best procedure.
There are several types of ptosis procedures that Dr. Zoumalan performs; some require an incision from the skin surface of the eyelid (anterior approach), while others are performed on the underneath surface of the eyelid (posterior approach). Both work well in most patients; however, Dr. Zoumalan will determine which would be a better fit for you based on your exam findings and desires. The patient may also wish to undergo cosmetic eyelid surgery in both upper and lower lids, which can certainly be done at the same time.
Long standing ptosis can be seen in isolated cases where the lid is droopy or in other cases where there is also excess skin around the eyelid. Both conditions can be addressed at the same time of surgery if they are present. Dr. Zoumalan often performs ptosis surgery and upper lid blepharoplasty to help restore the eyelid position and also rejuvenate one’s appearance. Both come hand in hand in various settings, and Dr. Zoumalan can help determine that after he examines you.
Revisional Ptosis surgery
Despite having a high success rate, ptosis surgery may often require revision if the eyelid position is still too low or too high after undergoing prior surgery. Dr. Zoumalan does see and treat patients who require revisional ptosis surgery, and a consultation is required to full assess your lid condition and whether you would be a candidate for revisional ptosis surgery.
For more information on Ptosis surgery or on revisional ptosis surgery, contact our office today to schedule an appointment with Dr. Zoumalan.