Eyelid Ptosis in Tampa and St. Petersburg, FL
Sagging upper eyelids is a medical condition known as “eyelid ptosis.” The condition affects your appearance by covering a portion of the eye, thus interfering with vision. Eyelid ptosis can be treated by surgery, and Dr. Dean G. Davis specializes in eyelid ptosis treatment. If you live in Tampa, St. Petersburg, or the surrounding areas, please contact our office today to schedule a consultation.
What is Ptosis?
Ptosis is a condition that refers to a droopy upper eyelid that occurs when one or both eyelids begin to droop. It is referred to as unilateral ptosis when it affects only one eye, and bilateral ptosis when both eyelids droop. Sometimes, the drooping is almost unnoticeable, or the upper eyelid may droop over the whole pupil. Children and adults can be affected by this condition. In the case of children, it is called congenital ptosis. Ptosis that affects adults is called involutional ptosis.
People living with ptosis will often unconsciously raise their eyebrows, causing horizontal lines and creases on the forehead. When skin is mostly tight, eyebrow raising can occur with eyelid elevation. Surgical correction of ptosis is a delicate and highly specialized procedure.
Drooping may worsen as the day progresses due to muscle fatigue, and the resulting effect is sometimes incorrectly called “lazy eye”. If left untreated, ptosis can lead to other problems, such astigmatism and amblyopia. This underscores the importance of early treatment to prevent improper vision development.
Congenital ptosis is usually due to a levator muscle developmental defect. The adult form of ptosis is typically accompanied by detachment or thinning of the tendon in the levator muscle. Trauma may cause droopy eyelids when it results in eyelid swelling. Another cause may be neurological conditions such as Horner’s Syndrome, myasthenia gravis, or oculomotor nerve palsy.
The chief feature and symptom of ptosis is a droopy eyelid. Those with ptosis may be sensitive about their appearance if the drooping is severe. Sometimes, vision may be impacted if the eyelid hangs low over the pupil. Those with ptosis will sometimes tilt their head back or constantly raise their eyebrows in order to see better.
Symptoms of eyelid ptosis Include:
- Impaired vision
- Eyelid heaviness
- Tilting the head to improve sight
- Constant eyebrow raising to lift the eyelid
- Headache as a result of eyestrain and forehead muscle strain
The degree of droopiness varies with each individual. If you suspect you have this condition, you should compare a recent picture of yourself with an older one to see if the position of your eyelids has changed over time. As you age, the skin is more stretched, and compensatory methods do not help as much as in the past. People who have had ptosis for a long period often say the droopiness is at its worst at the end of the day. Others complain that the eye affected is their dominant eye.
Forms of Upper Eyelid Ptosis
Congenital ptosis occurs when the droopy eyelid was present at birth because the muscle that lifts the eyelid did not fully develop. This muscle — the levator muscle — does not fully contract or completely relax. This form of ptosis can gradually worsen as a person ages because of natural skin changes caused by the aging process.
When the levator muscle is so undeveloped it cannot function, a very specialized surgical procedure known as a frontalis sling will be needed. This procedure anchors the upper eyelid to the frontalis muscle with the aid of materials such as silicone and “fascia lata”. The purpose of the frontalis muscle is raising the eyebrows.
Acquired ptosis occurs when the ptosis is not inherited and may happen due to a number of causes. The most common form of adult ptosis is involutional ptosis, which normally happens because of age. It involves a thinning or stretching of the levator muscle’s tendon that helps lift the eyelid. Many of those with this problem are annoyed by the strain required to keep their eyelids open as each day progresses. This form of ptosis may happen following cataract surgery, laser vision correction, LASIK, and other types of eye procedures. The acquired form of ptosis may be associated with neurological conditions such as Horner’s syndrome, stroke, 3rd nerve palsy, and myasthenia gravis.
Ptosis can also be caused by an artificial or prosthetic eye. A prosthetic eye sometimes causes the levator muscle to thin and stretch. Also, the shape, weight, and insufficient natural lubrication may cause ptosis. An ocularist may alter the prosthesis shape to force the eyelid upward, but this can cause it to become heavy and uncomfortable. This can be corrected to make the prosthesis smaller and more comfortable as a result.
Children With Ptosis
In the case of congenital ptosis, correction is possible if there is no significant difficulty involving visual information prior to the age of six. This would be performed later in the child’s life when it is involved more with aesthetics. Surgery can be performed if the condition affects the child’s vision before they reach the age of six. It is advised that the parent first consult with a pediatric ophthalmologist.
Childhood ptosis is often caused by an undeveloped levator muscle that fails to lift the eyelid. In this type of case, the child would first need a frontalis sling procedure for the development of unobstructed vision. When children have the frontalis sling procedure early in life, they have an easier time adapting to using the frontalis muscle to raise their eyelids than those who have it later in life.
Good Candidates for Ptosis Repair
When a droopy eyelid causes the upper eyelid to partially or completely obscure the vision, ptosis surgery may be required. Aggressive management often works best in the case of children for the proper development of vision.
Dr. Davis performs an evaluation by examining the eyelid. He examines the pupil’s center to gauge its relationship to the upper eyelid. If it is above a certain level, this does not indicate ptosis. When it is below this level, ptosis is present.
Ptosis Graded on a Scale From Mild to Severe
Those who are worried about asymmetry should know that not only the eyelids are involved, but also the bone structure underneath the skin. Human faces are never perfectly symmetrical. If a picture is taken of one-half of the face and flipped to make a complete face, it will not look exactly like the actual person’s face, revealing the previously unnoticed asymmetry.
How Is The Surgery Performed?
If the procedure is for an adult with ptosis, Dr. Davis will move the levator muscle forward by performing levator advancement surgery without sacrificing any part of it, unlike a resection. The goal of the procedure is to reposition the eyelid to the correct level.
Dr. Davis instructs his patients to open and close their eyes to achieve the correct symmetry, height, and cosmetic appearance. He will normally have the patient sit up while the surgery is ongoing and open and close their eyes. This helps him gauge the eyelid position so that it can be properly adjusted. Patients remain comfortable while this muscle is adjusted.
The surgery can last an hour or two, and is performed under local anesthesia using an IV drip.
Preparing for Your Ptosis Surgery
In preparation for ptosis surgery, you need to minimize your chances of complications such as infection and bleeding. You can do this by avoiding the use of blood thinners such as NSAIDS or ibuprofen, aspirin, Ginkoba, and Vitamin E. Be sure to inform Dr. Davis of all medications and supplements you are taking before your surgery.
If you currently have chronic eye conditions such as allergic conjunctivitis or dry eye, you must manage them properly before your surgery takes place. You should inform Dr. Davis of any eye conditions you may have before your procedure. You must also participate in a full review of your medical history with Dr. Davis prior to surgery.
Will I notice any change in my eyesight after my surgery?
Most people have some improvement in their vision following surgery since a droopy eyelid can interfere with their sight. In some cases, ptosis can result in a mild form of astigmatism, requiring a subsequent change in eyeglasses or contact lenses.
How Much Does Eyelid Ptosis Surgery Cost?
As explained on the blepharoplasty page, if done for medical purposes, it may be covered by your health insurance. Otherwise, we accept, cash, checks, credit cards, financing with CareCredit® and monthly payment plans.
Eyelid ptosis causes a range of physical and emotional issues that are easily corrected with appropriate plastic surgery. Davis Facial Plastic Surgery is a leading provider of eyelid ptosis surgery in the Tampa, St. Petersburg, and surrounding areas. Contact our office today to schedule a personal consultation with Dr. Davis.