A drooping eyelid can be caused by ptosis. The muscle that elevates the eyelid, is called the levator palpebrae superioris. It can dehisce from its attachment due to aging, trauma, prolonged contact use, or congenital abnormalities. It can also be associated with neuromuscular diseases like myasthenia gravis.
Treatment may be due to cosmetic or functional reasons. Severe drooping may obstruct the visual axis. If ptosis interferes with a patient’s vision, a brief surgical procedure can be performed to eliminate the drooping under local anesthesia or monitored anesthesia. This can be done in conjunction with a blepharoplasty or can be done independently.
Children with ptosis should be examined regularly to check for other vision problems by a pediatric ophthalmologist to monitor for refractive errors that can cause amblyopia.
This is usually performed with the use of a CO2 laser for precise incisions and dissection of surgical planes under local anesthesia, so that lid symmetry can be evaluated intra-operatively. It usually takes about 30-45 minutes to perform. A scarless procedure can also be done by making an incision from the backside of the eyelid as well. This can be done in conjunction with an upper or lower lid blepharoplasty, peri-ocular, or full face and neck laser skin resurfacing.
This varies per patient, but about 80% of swelling decreases by month 1, and the residual 20% can take several months to resolve. The stitches placed usually dissolve in about 10 days to 2 weeks (sometimes non-dissolvable stitches are placed and are removed at week 1) and patients are usually seen at the following intervals postoperatively: 1 week, 1 month, 3 months. No bandages are placed after the procedure, but detailed instructions will be given about ice and head positioning to decrease swelling after the procedure. Adjustments may need to be made around week 1.
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