Ptosis Repair
in New Jersey

82 Main St,
Chatham, NJ 07928
(973) 520-0494
Map & Directions

Ptosis is the drooping of the upper eyelid. While ptosis is usually the result of aging, some people develop ptosis after eye surgery or an injury, and sometimes the condition is congenital. Because ptosis may be present due to serious causes, patients with this disorder should be checked by a doctor.

What causes Ptosis?

Typically, ptosis results from a weakening in the muscle responsible for raising the eyelid or from damage to the nerves that control the muscle. In some cases, ptosis may simply be caused by loose skin on the upper eyelid. Sometimes, however, the reason for ptosis is more troubling. In addition to the possibility of the disorder occurring as a congenital condition, or as a consequence of an injury or surgery, ptosis may be caused by:

  • Migraine headache
  • Growth in the eyelid, such as a style
  • Bell’s palsy
  • Diabetes
  • Stroke
  • Myasthenia gravis
  • Horner syndrome
  • Benign or malignant tumor

In rare instances, ptosis can occur due to a brain tumor or other malignancy that affects the reactions of muscles or nerves.

What are the symptoms of Ptosis?

Ptosis presents as the drooping of one or both eyelids and perhaps one or more of the following symptoms:

  • Increased tear production
  • Difficulty blinking or closing the eye
  • Reduced vision (with severe drooping)

Since ptosis caused by aging is usually gradual, a sudden onset of symptoms is greater cause for concern.

How is Ptosis diagnosed?

Ptosis is typically diagnosed by an ophthalmologist, who can also frequently determine the cause of the problem. In order to perform a comprehensive eye examination, the doctor may test visual acuity, perform visual field testing, a slit-lamp examination, and, possibly, a tension test for myasthenia gravis.

If there is a suspicion of an underlying systemic disease, the patient will be referred to an internist or another physician for further investigation.

What is the treatment for Ptosis?

Patients may seek treatment for droopy eyelids for cosmetic or medical purposes. Severe drooping may obstruct vision as the eyelid gradually droops lower and lower, eventually covering the eye. If ptosis interferes with a patient’s vision, a blepharoplasty will be performed to eliminate the drooping. Many young patients with mild to moderate ptosis should be examined regularly to check for other vision problems including amblyopia, refractive errors and muscular diseases.

FAQ: Ptosis Repair (Droopy Eyelid Repair)

What is a droopy eyelid?

A droopy eyelid, also known as ptosis, is when the upper eyelid margin (the area where the eyelashes are) lowers in position causing the eye to appear smaller. This is often due to a disinsertion or stretching of the muscle that elevates or opens the eye. Occasionally, it may be related to a weakening of the muscle from neurologic disorders or one may be born with a congenitally weakened muscle.

What are the causes of a droopy eyelid?

A droopy eyelid can sometimes occur after eye surgery, trauma, or long term use of hard and sometimes soft contact lenses. Some patients are born with a congenital ptosis. Certain neurologic disorders can lead to a droopy eyelid.

Can a droopy eyelid be repaired?

The first step is to diagnosis the droopy eyelid with an office exam. Measurements are taken to assess the degree of droop and to understand the underlying issue. In some cases, further diagnostic testing may be required. If it is determined that the drooping is secondary to a mechanical issue, meaning a stretching or disinsertion of the muscle, there are 2 different types of surgeries that may be considered. The first is an external levator advancement and the second is a mullerectomy. It will also be determined whether one or both eyelids should be repaired for balance and symmetry.

Where is the incision for the surgery?

In the case of a mullerectomy surgery, the incision is created on the back surface of the eyelid. The procedure takes approximately 30 minutes. If you are not a candidate for mullerectomy surgery, an external levator advancement can be performed. This incision is made in the eyelid crease and sutures are placed and removed approximately one week later. This surgery takes approximately 45 minutes.

What is the recovery time?

Since the incision is on the back surface of the eyelid, the recovery time for a mullerectomy surgery is less. There is less bruising and swelling. Most patients feel comfortable returning to their daily activities 1-3 days after surgery although this may vary. For an external levator advancement surgery, there may be slightly more swelling and bruising with patients returning to their daily activities approximately 4-7 days after surgery. We recommend avoiding heavy exercise for 2-3 weeks. Ninety percent of the swelling is improved after one month. The lid position can fluctuate the first few weeks because of swelling and after 1-3 months patients can expect to see their final result.

What are the possible side effects of surgery?

Any surgery around the eye can lead to a temporary dry eye. This can manifest as tearing, burning or blurry vision. We recommend the use of preservative free artificial tears frequently during the first week to help minimize dry eyes. There is risk of the eyelid being too high or too low or asymmetric to the opposite eye. These possibilities are taken into consideration when developing a treatment plan and choosing the surgery that is predicted to yield that best results. The risk of scarring along the incision is low because the eyelid skin heals very good and the incision is hidden in the eyelid crease.


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