Ptosis is the medical term for a drooping lid. A patient who has ptosis is unable to fully open the eye because the upper lid covers the pupil. The ptosis correction intervention is performed under local anesthesia, so the patient goes home the same day and a very quick recovery follows.

Although the procedure for children is the same, it needs to be done under general anesthesia.

Ptosis can occur later in life if the muscles or ligaments that normally lift the eyelid are weakened by injury or disease. Sometimes drooping is the result of damage to the nerves that control the muscles of the eyelids. Most ptosis only occurs with aging. As a person ages, the skin and muscles of the eyelids stretch and weaken. Sometimes, prior eye surgery hastens this change, as the instruments used to hold the eye open during surgery can stretch the eyelid.

• Symptoms

It can be present at birth, which is why it is called congenital and occurs due to developmental errors while the child is still in the mother’s womb. If a child is born with ptosis that prevents normal vision, it is necessary to perform an operation as soon as possible, because the child’s eye will not develop and will remain poorly sighted throughout its life. Acquired ptosis in adults occurs as a result of injuries or degenerative age-related changes in the muscles and tendons of the lids caused by aging.

Symptoms of a drooping lid in children and adults:

• Visible drooping lid of one eye
• The upper lids of both eyes are not equal
• He tilts his head back, raises his chin, or raises his eyebrows to see better.

Over time, these movements can cause head and neck problems. Sometimes, a child born with ptosis may also have other eye-related problems. These can include eye movement problems, eye muscle disease, tumors (on the eyelid or elsewhere), and other problems. If a child’s eyelid droops so much that it blocks vision, amblyopia (also called “lazy eye”) may develop. One eye will have better vision than the other. It can also develop astigmatism (cylinder), as well as strabismus (curvature of the eyes).

People suffering from chronic dry eye, hypertension, circulatory disorders, thyroid disorders, diabetes or heart disease if their condition is regulated and stable are candidates for this intervention. For people with myasthenia gravis, there is a possibility of reoperation.

An oculoplastic examination is performed to check the condition of the lids and vision. Additional diagnostic tests such as a visual field test to determine if there are blind spots in the peripheral vision may be done if needed. Photos are also taken to monitor the result before and after the intervention. During the examination itself, you talk to the ophthalmologist about the result you want to achieve from the intervention and how possible it is in your case, that is, what you can realistically expect.

Preoperative preparation takes about 20 minutes. Patients with chronic diseases, depending on the therapy they are receiving, have special preparations that they are informed about on the day of the surgery appointment.

The preparation begins with the nurse taking an anamnesis. Blood pressure and sugar are checked. Then, in consultation with the ophthalmologist, if necessary, additional diagnostic tests are performed.

After the patient is fully prepared, he is brought into the operating room.

The intervention is performed with local anesthesia. If necessary, it can be performed under general anesthesia, with an anesthesiology examination being performed beforehand.

The choice of intervention depends on the type and degree of ptosis. If the muscle that raises the lid (levator palpebrae) has preserved part of its function, the operation is performed by shortening it. If by chance that muscle does not have a sufficiently preserved function, the lid is tied with a special procedure to the muscles of the forehead that take over the function of the lid (the so-called brow suspension).

Ptosis surgery is performed under local anesthesia with sedation (the patient is awake, but does not feel the procedure). Although the procedure for children is the same, it must be done under general anesthesia.

Types of surgery to repair a drooping lid include the following:

• The surgeon makes an opening in the skin of the upper eyelid. This allows the surgeon to find the small muscle that lifts the eyelid. The surgeon places stitches to tighten this muscle and lift the eyelid. The eyelid skin incision is then closed with more sutures.
• The surgeon can perform the entire operation from under the eyelid. In this case, the eyelid is inverted and the muscle is tightened from below. This approach does not require an incision in the skin.

Ptosis surgery can be done together with blepharoplasty. Blepharoplasty is an operation that removes excess skin on the eyelids that can contribute to drooping of the eyelid.

After the intervention, the next day is the first control, after a week and a month. The patient is prescribed therapy (antibiotic/corticosteroid drops and ointment) and is obliged to use it according to the time period specified by the ophthalmologist. It is advisable to sleep with the head on a higher pillow for a few days, and to wear dark glasses to protect the skin from the sun and wind. Bruising and swelling are expected to occur, which will slowly subside over 10 to 14 days. It takes several months for scars from surgical incisions to fade completely. In certain cases this intervention may need to be done again.

Restrictions after ptosis correction are temporary and do not last long and are always according to the surgeon’s recommendation.

In the first days after the operation, washing the face with plain water and rubbing the eye should be avoided, and for the first month, heavy exertion and heavy lifting should be avoided. It is especially important to use the prescribed therapy regularly and correctly. Also, contact lenses should not be worn for two weeks after the intervention.

Sports activities are usually allowed already 2-3 weeks after the operation, depending on the age of the patient and the intensity of exercise.

The medical staff is available 24/7 for any consultation that is needed after the operation.

The package includes: intervention with local anesthesia, three check ups and therapy.

It is possible to pay in installments without interest and additional costs.

You can check more about the payment method on the current price list of Sistina Ophthalmology.