Drooping upper eyelids: an ophthalmologist explained how ptosis affects vision

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An ophthalmologist of the highest category, an ophthalmologist surgeon, a candidate of medical sciences, spoke about the causes of ptosis of the eyelids and possible complications for vision in the absence of effective and timely treatment.

Congenital and acquired ptosis

Ptosis is a drooping or drooping of the upper eyelids caused by excessive relaxation or damage to the muscles that hold the eyelids in an upright position. It can be congenital or acquired.

Congenital ptosis occurs due to a muscle defect, underdevelopment of the nervous system, injury to the muscles during birth, or heredity. It can also be caused by paralysis of the oculomotor nerve, which controls the muscles of the face, if it is damaged and does not function properly. This can lead to temporary or permanent loss of movement and sensation in the facial area.

Among the causes that provoke the development of acquired ptosis, I highlight:

• injury to the muscles or nerves that control eyelid elevation;
• neoplastic tumors that grow through the muscle, disrupting its function;
• aging – with age, the muscles and tissues of the eyes lose tone;
• nervous disorders: myasthenia gravis, botulism, polyneuropathy, etc.;
• diabetes;
• myotitis or muscle inflammation;
• myopathy – a group of neuromuscular diseases that lead to gradual thinning and loss of muscle function;
• stroke;
• complications after surgeries performed on the eyes (cataract treatment) or eyelids (age-related changes correction), etc.

The impact of eyelid ptosis on vision

Plopping eyelids is not only an aesthetic problem. Depending on how severely they are drooping, ophthalmological disorders and diseases that are complications of ptosis may occur, including:

1. amblyopia or lazy eye – decreased visual acuity due to the lack of a full connection between the eyes and the brain;

2. strabismus – a visual disorder in which one or both sides deviate from the visual axis in the direction of the object;

3. astigmatism – a disease in which the cornea and/or lens have an irregular, slightly flattened shape, something like a melon or an American football. Because of this, light rays focus on the retina not at one point, but at several: some behind or in front of the retina, others on the retina, creating the effect of “fog” or doubling;

4. chronic conjunctivitis – inflammation of the mucous membrane, i.e. the conjunctiva, which covers the surface of the eye and the inner surface of the eyelids.

Ptosis also worsens the quality of life, as less light reaches the retina, and the eyes quickly get tired while reading or working at a computer. The field of vision decreases, especially if the degree of ptosis is complete. There is also partial and incomplete ptosis, which cause a person moderate discomfort. But over time, incomplete ptosis usually transforms into complete.

Treatment of ptosis

Incomplete and partial ptosis of the eyelids can be treated with eye exercises, local physiotherapy, and medications that nourish the nervous tissue and restore the sensitivity of nerve endings.

Complete or congenital ptosis is treated only with surgical intervention – muscle surgery. During the operation, the muscles responsible for lifting the eyelids are tightened. Thanks to this, the view is “opened” and the person can again fully read, work, study without visual fatigue and discomfort.

The treatment method depends on the cause of the drooping eyelids, which must be previously established during a comprehensive examination. In some cases, it is advisable to undergo a course of physiotherapy treatment before surgery.

In any case, drooping eyelids are a serious disorder that cannot be ignored not only because of the aesthetic component, but also because it can significantly worsen the health of your eyes.