in Seattle WA
What is Ptosis?
Ptosis is also called “drooping eyelid.” It is caused by weakness of the muscle responsible for raising the eyelid, damage to the nerves that control those muscles, or looseness of the skin of the upper eyelids.
Drooping eyelids can be caused by the normal aging process, a congenital abnormality (present before birth), or the result of an injury or disease.
Ptosis Risk Factors
Risk factors include aging, diabetes, stroke, Horner syndrome, myasthenia gravis, and a brain tumor or other cancer, which can affect nerve or muscle reactions.
- Drooping of one or both eyelids
- Increased tearing
- If the ptosis is severe, interference with vision.
Ptosis Treatment in Bellevue, WA
Dr. Tarbet will do a physical examination to determine the cause, as well as take pictures. A visual field test will also be required to determine if it is medically necessary. This test takes about forty-five minutes. In some cases, a special test may be done to evaluate suspected causes, such as myasthenia gravis.
If an underlying disease is found, the treatment will be specific to that disease. Most cases of ptosis are associated with aging and there is no disease involved.
Surgery can be done to improve the appearance of the eyelids in milder cases if the patient wants it. In more severe cases, surgery may be necessary to correct interference with vision. In children with ptosis, surgery may be necessary to prevent amblyopia (lazy eye).
The expected outcome depends on the cause of the ptosis. Surgery is usually very successful in restoring appearance and function.
What are the non-surgical treatment options for ptosis?
While you may have heard claims of eye drops or creams addressing ptosis if they do anything at all it’s usually only for a few hours. Skin tightening treatments, such as those using radiofrequency energy, are also only good for a couple of weeks before the eyelid droops again.
Dr. Tarbet has had success with Botox injections in some patients. If Botox is injected into the upper outer brow and various specific points on the forehead, this can help to open the eyelids and it takes the weight off the brows and sub-brow tissue of the upper eyelids. Botox injections are not permanent solutions, as their results last from 4-6 months.
Really the only effective treatment for ptosis is surgery to address the levator muscles that lift the eyelids.
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What happens if I leave my ptosis untreated?
Ptosis will not resolve on its own. If you leave your sagging eyelids untreated, they will simply droop lower and lower. In some patients, they will eventually begin to hinder vision. If nothing else, the drooping eyelids of ptosis will make your face age dramatically.
Can ptosis be caused by stress?
Ptosis is not caused by stress. In some cases, ptosis can be caused by conditions that injure the brain or its cranial nerves. This is because the eye muscles are controlled by nerves that come from the brain. But this is a sign of a stroke, a brain tumor, a brain aneurysm, or nerve damage due to diabetes; it is not due to stress.
Can mild ptosis correct itself?
Ptosis will not resolve itself, as it is typically due to issues with the muscles that control the eyelid. Mild ptosis will advance to moderate ptosis.
When is eyelid surgery necessary to correct ptosis?
The drooping of ptosis doesn’t require surgery in the early stages. And for some people who are not bothered by the sagging in their eyelids, surgery may never be necessary. But if the drooping eyelid or eyelids begin to infringe upon your field of vision, then surgery is necessary. Fortunately, once your vision becomes impaired by the drooping eyelid insurance typically will cover the procedure.
Others don’t like the way their drooping eyelids age their face. After all, the eyes are the focal point of the face, so if your eyelids are sagging and droopy that will make your overall face look older. This is the basis of blepharoplasty, cosmetic eyelid surgery. Ptosis surgery isn’t focused on removing excess skin, as in blepharoplasty, but on tightening the levator muscles.
What’s the difference between ptosis and amblyopia (lazy eye)?
Amblyopia is a vision development disorder that typically is a problem of infant vision development. With amblyopia, the brain ignores the signals it is receiving from one eye. This can be due to differences in refraction between the two eyes and other causes. As the brain ignores the eye, the other eye begins to dominate. The “lazy eye” can eventually have a permanent loss of vision if amblyopia is not addressed.
Amblyopia is usually treated by the child wearing an eye patch. This makes the “lazy eye” have to work, and the brain is forced to use the input from the eye for vision.
There are three types of amblyopia, based on the cause:
- Strabismic amblyopia — This is the most common cause, where the infant’s eyes are misaligned. The brain ignores the visual input from the misaligned eye, leading to a lazy eye in the ignored eye.
- Refractive amblyopia — If one eye has significantly different refractive errors than the other, for instance, one eye could have significant near or farsightedness and the other does not, then the brain will ignore the eye with the blurred vision.
- Deprivation amblyopia — This rarer form is caused by something obstructing the light from entering and being focused in the baby’s eye, such as a congenital cataract. Again, the brain will begin to ignore the impaired eye.
As mentioned above, ptosis has nothing to do with the brain; it is simply due to sagging and drooping of the eyelid. This is usually due to the passage of time and the slackening of skin and support muscles. Ptosis can also be a side effect from blepharoplasty or from an eye injury.