What's Ptosis?

Ptosis, often misunderstood by the general public, is an eye condition that manifests as an unusual drooping of the upper eyelid, usually due to damage to the eyelid levator muscle. Typical symptoms include partial closure of the eyelid, which can impair the visual field, and difficulty in reading, especially when looking down. Consulting a healthcare professional for an eyes examination is important if experiencing symptoms of ptosis to determine the underlying cause and discuss appropriate treatment options.

The origins of Ptosis

Ptosis can result from a variety of causes, including:

  • Congenital ptosis: The most common, this type of ptosis is detected at birth and is due to a congenital anomaly of the levator muscle of the upper eyelid. Depending on their severity, they can influence a child's visual development and even cause amblyopia.
  • Aponeurotic ptosis: Generally observed in the elderly, these ptosis result from dehiscence or disinsertion of the levator muscle aponeurosis. They are the most common form of acquired ptosis.
  • Myogenic ptosis: These occur as a result of conditions such as myasthenia gravis, congenital myopathies or Steinert's myotonic dystrophy.
  • Mechanical Ptosis: Occurs when the muscles can no longer lift an eyelid that has become too heavy, often due to fatty prolapse, dermatochalasis or eyelid tumors.
  • Neurogenic Ptosis: Secondary to sympathetic nerve damage (Claude Bernard Horner syndrome) or oculomotor damage.
  • Traumatic Ptosis: Resulting from disinsertion of the levator muscle following certain types of trauma.


Who does Ptosis affect?

Ptosis can affect both men and women and can be present from birth or develop later. In children with severe congenital ptosis, muscular compensations can be observed, such as contraction of the frontal muscle with raised eyebrows and a particular position of the head to improve vision.

Diagnosis and treatment of Ptosis

The diagnosis of ptosis is essentially clinical, involving a thorough ophthalmological examination to assess the severity of the condition. Orthoptic tests may be performed to detect possible amblyopia, while further examinations, such as slit-lamp examination, may be necessary to identify other associated ocular abnormalities.

As far as treatment is concerned, surgery remains the main option. Several surgical techniques can be used, depending on the cause and severity of the ptosis, including plication or shortening of the levator muscle, suspension of the eyelid from the forehead muscles or conjunctival mullerian resection. The procedure is usually performed under thorough local anesthesia in outpatient surgery, although general anesthesia may be required for children. 

Although ptosis may seem merely cosmetic, it can have a significant impact on vision and quality of life. It is therefore crucial to consult your optometrist for an accurate diagnosis and to discuss treatment options tailored to each individual case.