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 vision.
There are two basic surgical procedures to correct ptosis. The strength of the muscle in the eyelid determines which operation is performed. They are usually done with sedation anesthesia.
Tightening / Resection
If the opening muscle has some strength and can elevate the eyelid, then the 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.
Either because of the tightness of the shortened muscle or because of the material that was attached to the eyebrow muscle, your eyelids may not close completely in the first week or two. This is temporary for most patients. For others who do not have elasticity in their eyelid muscles, this condition will persist. This will not cause a problem as long as the protective eye mechanisms and tears are normal. No dryness of the eye from the small separation of the eyelid(s) will result if these mechanisms are normal. Some patients require lubricants.
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 somewhat lower in our practice.