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- What Is Ptosis, What Causes It & How Is It Usually Treated?
What Is Ptosis, What Causes It & How Is It Usually Treated?
The process of finding the correct treatment for a facial or neurological condition can in some cases be a matter of diagnosing and differentiating between conditions that have similar symptoms, whilst in other cases it is about finding the right treatment for the root cause.
The case of ptosis is an example of the latter, as whilst the eyelid drop is typically treated as a single condition or symptom, it can have a variety of potential causes, with a treatment pathway dependent on the underlying condition.
To understand why, it is important to understand what ptosis is, its multitude of causes and the most common causes of treatment.
In some cases, the effect is mild and thus primarily cosmetic, whilst in other cases, it can be very difficult if not impossible to keep the affected eyelid from partially or completely affecting vision.
This can lead to fatigue and eye strain due to the increased effort of keeping the eye open, as well as watery eyes, dry eyes as blinking helps with moisture, and headaches. It can also sometimes cause double vision, but this is rarer.
It can affect one eye or both to varying degrees and if the eyelid drops enough to affect vision it can cause amblyopia (lazy eye), where the brain favours one eye over the other, eventually leading to progressive vision degeneration in the affected eye.
It can also potentially lead to astigmatism, a condition that can cause blurred vision due to the pressure the eyelid is forcing on the front of the eye, or it can lead to neck strain if you tilt your chin upwards to look past the eyelid without opening it.
In some very rare cases, the eyelid droops but will lift when the mouth is open, a phenomenon known as jaw-winking or Marcus Gunn Syndrome.
A case of congenital ptosis is typically present at birth, although it can also progress over time, and is believed to be biologically inherited. It is a relatively rare condition in general, but it is most commonly caused by a defect in the muscles which raise the eyelids.
Most cases of ptosis are acquired, typically as the result of an underlying condition, age causing muscular degeneration or as the result of an injury to the eye or the nerves which control it.
It can be caused by eye infections such as conjunctivitis, blepharitis or styes, allergic reactions, a stroke or a brain tumour. Because of this, ptosis is a condition that will often be carefully investigated as soon as someone visits a doctor in order to rule out more serious side effects.
It can also sometimes be caused by stress, trauma or as a side effect of neurological conditions such as Horner syndrome.
Treatment will vary depending on the underlying cause, and if a root cause is discovered, it is typically treated first in order to determine if this stops the eyelid drop. In many cases, this will help to relieve the symptoms without the need for further interventions.
In some cases, it can be treated with oxymetazoline hydrochloride eye drops, which are used once daily to relieve the heavy eyelid effect of acquired ptosis. These are not effective for every case of ptosis, so they will only be prescribed if a doctor is sure that they will work.
In other cases, particularly if the cause of the eyelid drooping is known to be temporary, a type of glasses frame known as ptosis crutches may be used instead.
The most common treatment, however, is surgery on the eyelid.
This will typically involve shortening the muscles that help raise the eyelid before reattaching them. Alternatively, it can sometimes involve lifting the eyebrows, or a combination of the two treatments.
The result is not only cosmetic but also improves vision, reducing eye strain and assisting with overall quality of life.
Learn more about our advanced radiotherapy and neurosurgical treatments for ptosis on the Queen Square website.
The case of ptosis is an example of the latter, as whilst the eyelid drop is typically treated as a single condition or symptom, it can have a variety of potential causes, with a treatment pathway dependent on the underlying condition.
To understand why, it is important to understand what ptosis is, its multitude of causes and the most common causes of treatment.
What Is Ptosis?
Ptosis is the medical term given to heavy, droopy or sagging upper eyelids, which can vary in severity and its effect on a person’s quality of life.In some cases, the effect is mild and thus primarily cosmetic, whilst in other cases, it can be very difficult if not impossible to keep the affected eyelid from partially or completely affecting vision.
This can lead to fatigue and eye strain due to the increased effort of keeping the eye open, as well as watery eyes, dry eyes as blinking helps with moisture, and headaches. It can also sometimes cause double vision, but this is rarer.
It can affect one eye or both to varying degrees and if the eyelid drops enough to affect vision it can cause amblyopia (lazy eye), where the brain favours one eye over the other, eventually leading to progressive vision degeneration in the affected eye.
It can also potentially lead to astigmatism, a condition that can cause blurred vision due to the pressure the eyelid is forcing on the front of the eye, or it can lead to neck strain if you tilt your chin upwards to look past the eyelid without opening it.
In some very rare cases, the eyelid droops but will lift when the mouth is open, a phenomenon known as jaw-winking or Marcus Gunn Syndrome.
What Causes Ptosis?
There are a lot of different causes of ptosis that can be categorised as either congenital or acquired.A case of congenital ptosis is typically present at birth, although it can also progress over time, and is believed to be biologically inherited. It is a relatively rare condition in general, but it is most commonly caused by a defect in the muscles which raise the eyelids.
Most cases of ptosis are acquired, typically as the result of an underlying condition, age causing muscular degeneration or as the result of an injury to the eye or the nerves which control it.
It can be caused by eye infections such as conjunctivitis, blepharitis or styes, allergic reactions, a stroke or a brain tumour. Because of this, ptosis is a condition that will often be carefully investigated as soon as someone visits a doctor in order to rule out more serious side effects.
It can also sometimes be caused by stress, trauma or as a side effect of neurological conditions such as Horner syndrome.
How Is Ptosis Typically Treated?
In some cases, ptosis does not need treatment. This is usually if the effect is minor and does not affect vision or does not affect it enough of the time to necessitate treatment. Surgery is an option even if it is not affecting eyesight, depending on if there are concerns that the condition could progress.Treatment will vary depending on the underlying cause, and if a root cause is discovered, it is typically treated first in order to determine if this stops the eyelid drop. In many cases, this will help to relieve the symptoms without the need for further interventions.
In some cases, it can be treated with oxymetazoline hydrochloride eye drops, which are used once daily to relieve the heavy eyelid effect of acquired ptosis. These are not effective for every case of ptosis, so they will only be prescribed if a doctor is sure that they will work.
In other cases, particularly if the cause of the eyelid drooping is known to be temporary, a type of glasses frame known as ptosis crutches may be used instead.
The most common treatment, however, is surgery on the eyelid.
This will typically involve shortening the muscles that help raise the eyelid before reattaching them. Alternatively, it can sometimes involve lifting the eyebrows, or a combination of the two treatments.
The result is not only cosmetic but also improves vision, reducing eye strain and assisting with overall quality of life.
Learn more about our advanced radiotherapy and neurosurgical treatments for ptosis on the Queen Square website.
