In the medical world, droopy eyelids are called “Ptosis.” This condition can cause the upper eyelid to block the vision in one or both eyes, which can create a problem when someone tries to read, drive or watch TV. Ptosis is also frequently associated with extra skin on the upper eyelids – a condition known as dermatochalasis.

Why Do These Droopy Eyelid Conditions Occur?

These conditions are most commonly seen as we get older. Wear and tear throughout the years leads to a loosening of the support structures of the eyelids – which can then cause the eyelid to droop. The extra skin can actually hang over the upper lid, creating what looks like an awning that can get in the way of vision.

Other causes of ptosis include neurologic conditions and bumps such as styes or skin cancer that are pressing down on the eyes. Babies can even be born with a type of ptosis known as congenital ptosis. If you think you might be suffering from ptosis, call to set up an appointment at Matossian Eye Associates – (800) 708-8800.

What Happens at a Ptosis Appointment?

At your visit, your surgeon will check your vision, pupils, and the motility of the eyes (eye muscles) to determine the cause of the droopy eyelids. He will then take some measurements to determine how severe the droopy eyelids are and the best way to correct them.

Your surgeon will then take photos and conduct a visual field test, which will demonstrate the amount of vision loss that you are experiencing.

While there are many different procedures used to correct ptosis, I am going to discuss two of the most common.

The Two Most Common Treatments for Droopy Eyelids (Ptosis)

The first is called an “external levator resection and functional blepharoplasty.”  That’s a big term, and it basically means removing excess skin to correct the droopy eyelids caused by aging. It is typically performed in the surgery center, but can also be done in the office in select cases.  Either way, it is a same-day surgery.

An incision is made in the eyelid crease so that any scar that forms will be hidden in the crease. The extra skin and fat is then removed, and one or more stitches are placed in the muscle of the upper eyelid to raise it.  Finally, the skin is stitched closed.

There is usually no pain afterward, but a prescription can be written for pain just in case. You will probably be out of commission for two days, and then it’s back to normal life, with the exception of no exercise for a week. The area will likely bruise and swell, which can be covered by sunglasses or makeup.

Risks of surgery include bleeding and infection (anytime you have surgery on the body). There is a 1 in 10,000 case that the patient can lose vision from the surgery – it’s probably risker crossing the street, but we do it – and finally there is about a 10% chance of asymmetry in the post-op period. This can be corrected in the first few weeks after the procedure.  

The vast majority of patients who undergo these treatments report greatly improved quality of life after having them done. The upper eyelid procedure can also be done as a cosmetic procedure if the droopy eyelids are not blocking vision, but the patient is bothered by the appearance of the eyelids.

The second approach to ptosis repair that I will discuss involves operating from the inside of the eyelid using a procedure called a Mullerectomy. This approach works well for patients who have a neurologic cause of their ptosis – something known as Horner’s syndrome.

At the initial visit, your doctor will place an eyedrop called phenylephrine in the eye to see if the eyelid elevates. If it does, you are likely a good candidate for this type of procedure.

Just like the first approach, this procedure can either be done in the surgery center under sedation or in the office under local anesthesia.  Either way, the surgery is same-day, outpatient procedure.

The under surface of the upper eyelid is secured, and a dissolvable stitch is then woven back and forth across the tissue. Then the extra tissue under the eyelid is removed. This procedure can be combined with excess skin removal from the outside of the eyelid if this needs to be addressed as well.

Just like with the first procedure, you will probably be out of commission for two days, and then it’s back to normal life, with the exception of no exercise for one week. The area will likely bruise and swell, which can be covered by sunglasses or makeup. The risks are the same as previously discussed.

At Matossian Eye Associates, Dr. Johnson performs these procedures with meticulous attention to detail. With an eye for aesthetics, he and his team truly help patients look, see, and feel their best. They are eager to meet you and happy to answer all your questions at your visit. Call 800.708.8800 or click here to schedule your consultation today!