Ptosis is a condition in which the upper eyelid excessively droops down over the eye. It can involve the upper eyelid of one or both eyes. Children can develop amblyopia (“lazy eye”) if the drooping eyelid obstructs the visual axis. They may adopt a chin-up head position and/or raise their eyebrow(s) to see beneath the eyelid margin to “fight for sight.” The weight of the drooping eyelid can also cause astigmatism by changing the curve of the cornea (the clear curved window at the front of the eye which focuses light) from being round like a basketball to more steeply curved in one direction than another, like a football; this causes images to be distorted and increases the risk of developing amblyopia.
TYPES OF PTOSIS
Congenital ptosis is present at birth and most commonly results from poor development of the levator muscle in the upper eyelid.
Acquired ptosis can occur secondary to trauma, systemic disease, neurologic disorder, or a number of other conditions that affect facial nerves and musculature.
If the drooping eyelid covers the pupil, causes significant astigmatism, or causes the child to adopt a chin-up head position, surgical intervention is usually recommended and revisions may be necessary as the child grows and develops. If visual development has been affected, amblyopia treatment may also be prescribed. Even if the ptosis is not initially visually significant, regular monitoring for vision abnormalities is still appropriate.