Congenital or Acquired
Ptosis (droopy upper eyelids), which can occur at birth or later in life, is generally due to hereditary tendencies, age changes, or injury. The main reason for having corrective surgery is to improve vision in the upper field of gaze; however, there is a beneficial cosmetic side effect. Corrective surgery is necessary in children who have ptosis in both eyes for proper visual development. Surgery is done in adults to improve visual field.
There are two basic surgical procedures to correct ptosis. The strength of the levator muscle in the eyelid determines which operation is performed.
Tightening / Resection
If the opening muscle has some strength and can elevate the eyelid, then the levator muscle can be tightened or resected. This elevates the lid to the desired level.
If a patient has poor strength of the eyelid muscle, tightening the muscle does not work well. This procedure uses the strength of the eyebrow muscle (frontalis muscle) to correct the droopy eyelid. A tiny silicone rod/band is passed inside the eyelid up into the eyebrow muscle where it is secured. This elevates the lid and allows the patient to use their eyebrow muscle to control the lid height.
Nationwide, approximately 25% of those having a ptosis repair need a secondary adjustment so that the best possible symmetrical results may be obtained; the percentage is 10% in our practice.