What Is Ptosis?

Ptosis is a drooping or falling of the upper eyelid. It can affect one or both eyes. The two main categories of ptosis are:

• Congenital
• Acquired

In Congenital ptosis the levator muscle (which opens the eye) does not develop properly. Babies are born with a drooping eyelid. Sometimes there is just a small droop and sometimes the eye barely opens at all. If the lid is blocking the visual axis, then the ptosis must be fixed so normal visual acuity develops.

Acquired ptosis is more common than congenital ptosis. There are 5 types of acquired ptosis. The first is aponeurotic ptosis. In this category of ptosis, the tendon of the levator muscle of the eyelid becomes stretched. This usually happens due to aging or long-term hard contact lens use.

Neurogenic ptosis occurs when there is a problem with the nerve pathway that controls movement of the eyelid muscle. Causes of neurogenic ptosis include myasthenia gravis, third nerve palsy, and Horner syndrome.

In myogenic ptosis, the levator muscle is weakened due to a systemic disorder that causes muscle weakness. These conditions may include chronic progressive external ophthalmoplegia and other types of muscular dystrophy.

With mechanical ptosis, the eyelid is weighed down by skin or an eyelid mass. This is a very common type of ptosis. When the excess skin or mass is removed, then the ptosis typically resolves.

Traumatic ptosis is caused by an injury to the eyelid. This trauma damages or weakens the levator muscle or its tendon.

If you think that you have ptosis, a full evaluation in the office can diagnose the severity and type. A minor surgical procedure can repair most categories of ptosis.

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