EYELID PTOSIS
Ptosis is a condition where the border of the upper eyelid is at a lower than normal position. In severe cases, the eyelid can cover all or part of the pupil and limit your field of vision in one or both eyes. Ptosis can be present at birth (congenital ptosis) or develop later in life.
Frequently Asked Questions
What causes eyelid ptosis?
Ptosis is caused by a slipped or weakened eyelid muscle. The most common cause of ptosis occurs when the muscle tendon that attaches to the eyelid slowly separates from the eyelid and the eyelid falls. The edge of the upper lid can slip into your line of sight and limit your field of vision. Ptosis is not a result of excess or redundant eyelid skin that is repaired by blepharoplasty.
What are the symptoms of Ptosis?
Symptoms include:
While ptosis is usually not associated with other problems, it may occur as a result muscular or neurologic disease, injury, or previous eye surgery. Drs. Agnone and Morrison will perform a thorough evaluation to look for other possible causes of ptosis.
How is an eyelid ptosis repaired?
When the edge of upper eyelid falls into the line of sight, with or without a lot of excess eyelid skin, the muscle can be reattached back into a more normal position with a ptosis repair surgery.
Will a ptosis surgery fix an eyelid that has baggy, excess skin?
No. When excess, baggy eyelid skin, sinking upper eyelids, or drooping skin/eyelashes impair vision, a blepharoplasty surgery is required. Sometimes a blepharoplasty is needed along with a ptosis repair surgery to return the edge of the eyelid to a more normal position and remove the baggy excess skin to help you look and see your best.
Will a ptosis surgery fix drooping eyebrows from advancing age?
No. Ptosis surgery restores the eyelid edge to a more normal position, but drooping eyebrows require a different surgery. After the ptosis repair, you will no longer need to use the muscles in your forehead to help open your eyes, and your eyebrows may relax to an even lower position. Some patients may require a ptosis repair surgery and a to help you look and see your best.
Are there other things I can do to besides surgery to fix ptosis?
No. The only way to repair ptosis is with surgery. However, there are ways to tighten eyelid skin. Drs. Agnone and Morrison may recommend injectable fillers, topical creams, gels and vitamins for your specific eye-area needs to enhance your appearance and aid the ptosis repair.
Will I be asleep for the procedure?
The ptosis repair surgery is performed under local anesthesia — while you are numbed, sedated, relaxed and awake — in an outpatient surgery center or hospital. There will be an anesthesia doctor present to monitor your heart, breathing and blood pressure during the procedure and to make sure you are completely comfortable. Patients typically return home within hours after the surgery.
Is the procedure painful?
No. You will be sedated and the area will be numbed before the procedure. Afterwards, usually Tylenol or ibuprofen controls the small amount of discomfort associated with the surgery. More intense pain should be reported to Drs. Agnone and Morrison immediately.
Is there anything I should do prior to surgery?
At your pre-operative visit, report all medications (prescribed and over the counter), vitamins, supplements, and herbs you take as some can increase your risk of bleeding. Aspirin, aspirin-containing products, non-steroidal anti-inflammatory agents, St. John's Wort, large amounts of supplements such as fish oil and vitamin E should be discontinued for one to two weeks prior to surgery to decrease the risk of bleeding. Your complete list of medications, supplements and herbs will be reviewed at the pre-operative visit to determine if any changes should be made prior to surgery.
How long does it take to heal after a Ptosis repair surgery?
There can be swelling and bruising after the surgery. Most patients recover quite quickly although there can be some bruising and/or swelling for up to several weeks. The swelling tends to be worse in the morning. Although you will have little discomfort and may feel well enough to return to work a few days after surgery, you should avoid strenuous activities and exercise for at least two weeks. It may take six to twelve weeks to regain normal strength in the slipped, weakened muscle.
Will there be a scar?
Incisions are made along the eyelid crease of the upper eyelid. There is a thin small scar in the normal eyelid crease that may take three to six months to fade from pink to white. Take care to protect your delicate eyelid skin from sun exposure during this time.
Are there any restrictions after a ptosis repair?
You must avoid swimming and hot tubs for three weeks. It is important to keep the area clean and use the ointment as recommended. You may shower and bathe normally, but do not rub the eye area. Although you will have little discomfort and may feel well enough to return to work a few days after surgery, you should avoid heavy lifting, bending, strenuous activities and exercise for at least two weeks. Avoid wearing contact lens and makeup for three weeks. Further instructions for post-operative care are provided after your surgery.
What are the risks associated with ptosis repair?
As with any surgery, ptosis repair carries some risks such as infection or reaction to anesthesia, temporary numbness of the eyelid skin, dry, irritated eyes, scarring and other risks. Drs. Agnone and Morrison will discuss risks specific to your situation.
Are the results permanent?
The results of ptosis repair surgery last a long time for many people. For others, advancing age and genetic factors may cause the eyelid position to become lower again, requiring another procedure.
Is ptosis repair surgery covered by insurance?
Ptosis repair is covered by insurance when the position of the upper eyelid causes a significant decrease in your visual field. It is considered cosmetic and not covered by insurance if your visual field is not impacted. Our office has financing available for cosmetic procedures.
Ptosis is a condition where the border of the upper eyelid is at a lower than normal position. In severe cases, the eyelid can cover all or part of the pupil and limit your field of vision in one or both eyes. Ptosis can be present at birth (congenital ptosis) or develop later in life.
Frequently Asked Questions
What causes eyelid ptosis?
Ptosis is caused by a slipped or weakened eyelid muscle. The most common cause of ptosis occurs when the muscle tendon that attaches to the eyelid slowly separates from the eyelid and the eyelid falls. The edge of the upper lid can slip into your line of sight and limit your field of vision. Ptosis is not a result of excess or redundant eyelid skin that is repaired by blepharoplasty.
What are the symptoms of Ptosis?
Symptoms include:
- difficulty keeping one or both eyes open -- initially worse when tired
- an eyelid position that is cosmetically unpleasing to you
- a decreased field of vision
- muscle ache and fatigue from tilting your head back or using forehead muscles to raise your eyebrows to minimize your reduced field of vision
- an odd, surprised appearance
While ptosis is usually not associated with other problems, it may occur as a result muscular or neurologic disease, injury, or previous eye surgery. Drs. Agnone and Morrison will perform a thorough evaluation to look for other possible causes of ptosis.
How is an eyelid ptosis repaired?
When the edge of upper eyelid falls into the line of sight, with or without a lot of excess eyelid skin, the muscle can be reattached back into a more normal position with a ptosis repair surgery.
Will a ptosis surgery fix an eyelid that has baggy, excess skin?
No. When excess, baggy eyelid skin, sinking upper eyelids, or drooping skin/eyelashes impair vision, a blepharoplasty surgery is required. Sometimes a blepharoplasty is needed along with a ptosis repair surgery to return the edge of the eyelid to a more normal position and remove the baggy excess skin to help you look and see your best.
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| Ptosis is caused by a slipped/weakened eye muscle. | A blepharoplasty removes excess eyelid skin. |
Will a ptosis surgery fix drooping eyebrows from advancing age?
No. Ptosis surgery restores the eyelid edge to a more normal position, but drooping eyebrows require a different surgery. After the ptosis repair, you will no longer need to use the muscles in your forehead to help open your eyes, and your eyebrows may relax to an even lower position. Some patients may require a ptosis repair surgery and a to help you look and see your best.
Are there other things I can do to besides surgery to fix ptosis?
No. The only way to repair ptosis is with surgery. However, there are ways to tighten eyelid skin. Drs. Agnone and Morrison may recommend injectable fillers, topical creams, gels and vitamins for your specific eye-area needs to enhance your appearance and aid the ptosis repair.
Will I be asleep for the procedure?
The ptosis repair surgery is performed under local anesthesia — while you are numbed, sedated, relaxed and awake — in an outpatient surgery center or hospital. There will be an anesthesia doctor present to monitor your heart, breathing and blood pressure during the procedure and to make sure you are completely comfortable. Patients typically return home within hours after the surgery.
Is the procedure painful?
No. You will be sedated and the area will be numbed before the procedure. Afterwards, usually Tylenol or ibuprofen controls the small amount of discomfort associated with the surgery. More intense pain should be reported to Drs. Agnone and Morrison immediately.
Is there anything I should do prior to surgery?
At your pre-operative visit, report all medications (prescribed and over the counter), vitamins, supplements, and herbs you take as some can increase your risk of bleeding. Aspirin, aspirin-containing products, non-steroidal anti-inflammatory agents, St. John's Wort, large amounts of supplements such as fish oil and vitamin E should be discontinued for one to two weeks prior to surgery to decrease the risk of bleeding. Your complete list of medications, supplements and herbs will be reviewed at the pre-operative visit to determine if any changes should be made prior to surgery.
How long does it take to heal after a Ptosis repair surgery?
There can be swelling and bruising after the surgery. Most patients recover quite quickly although there can be some bruising and/or swelling for up to several weeks. The swelling tends to be worse in the morning. Although you will have little discomfort and may feel well enough to return to work a few days after surgery, you should avoid strenuous activities and exercise for at least two weeks. It may take six to twelve weeks to regain normal strength in the slipped, weakened muscle.
Will there be a scar?
Incisions are made along the eyelid crease of the upper eyelid. There is a thin small scar in the normal eyelid crease that may take three to six months to fade from pink to white. Take care to protect your delicate eyelid skin from sun exposure during this time.
Are there any restrictions after a ptosis repair?
You must avoid swimming and hot tubs for three weeks. It is important to keep the area clean and use the ointment as recommended. You may shower and bathe normally, but do not rub the eye area. Although you will have little discomfort and may feel well enough to return to work a few days after surgery, you should avoid heavy lifting, bending, strenuous activities and exercise for at least two weeks. Avoid wearing contact lens and makeup for three weeks. Further instructions for post-operative care are provided after your surgery.
What are the risks associated with ptosis repair?
As with any surgery, ptosis repair carries some risks such as infection or reaction to anesthesia, temporary numbness of the eyelid skin, dry, irritated eyes, scarring and other risks. Drs. Agnone and Morrison will discuss risks specific to your situation.
Are the results permanent?
The results of ptosis repair surgery last a long time for many people. For others, advancing age and genetic factors may cause the eyelid position to become lower again, requiring another procedure.
Is ptosis repair surgery covered by insurance?
Ptosis repair is covered by insurance when the position of the upper eyelid causes a significant decrease in your visual field. It is considered cosmetic and not covered by insurance if your visual field is not impacted. Our office has financing available for cosmetic procedures.