The word PTOSIS is synonymous of fallen. Ptosis of the upper
eyelid means that the level of the upper eyelid is under the
normal parameters, and it interferes with the field of view.
It is classified depending on the moment of life in which it
appears, the conditions and what causes it.
Basically there are two classes of Ptosis of the upper
eyelid:
1.-Congenital Ptosis: It occurs when the patient is
born with this pathology.
2.-Acquired Ptosis: It is when the Ptosis appears for
the first time in any stage of life that is not birth.
3.- Congenital Ptosis can affect one or both upper
eyelids, and it is caused by a dystrophy of the eyelid’s
elevating muscle.
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The Acquired Ptosis can affect one or both eyelids depending
on the cause.
Among these causes we can find:
a. Neurogenic:
When there is an alteration of the Common Ocular Motor
nerve, which is the one that commands the elevating muscle.
b. Miogenic:
An alteration of the Elevator Muscle’s body occurs, as in
the Myasthenia Gravis
c. Aponeurotic:
It’s when the Aponeurosis of the Elevating Muscle detaches
partially or totally , or it stretches, or it debilitates.
This happens frequently and mainly to adult patients, on
one or both eyelids. It is related to aging or traumas. Some
say that the use of bifocal lens and contact
lenses could be another probable cause of Aponeurotic Ptosis
d. Mechanical:
A tumor in the upper eyelid or an excess of eyelid skin can
force the level of the eyelid to be under the normal
position. In this case the extirpation of the tumor or
an aesthetic blepharoplasty would help this condition
disappear. The treatment will depend on the cause.
Picture 1.-. - This is a patient with an Acquired Ptosis of
the upper eyelid, which has an Aponeurotic origin. The
patient came to my office to have it corrected. You can
observe the low level of the eyelid when looking forward.
Picture 2.- The ptosis can still be observed when patient is
looking upwards.
Picture 3.-
The ptosis is corrected performing a surgical plicature of
the Elevator’s Aponeurosis. Looking forward
Picture 4.- The results of the surgery, patient is looking
upwards.
