Drooping Upper Eyelid (Ptosis)

Ptosis (drooping of the upper eyelid) can be congenital, acquired and sympathetic.

Congenital ptosis is often hereditary and occurs due to underdevelopment or absence of the muscle that lifts the upper eyelid, as well as aplasia of the lateral nuclei of the oculomotor nerve.

The causes of acquired ptosis are injury to the muscle that lifts the upper eyelid, as well as damage to the oculomotor nerve and its centers due to injury, inflammatory processes and tumors.

Sympathetic ptosis develops with paralysis or paresis of the cervical sympathetic nerve caused by various reasons.

The main symptoms of ptosis are drooping of the upper eyelid from barely noticeable to complete closure of the palpebral fissure. With severe ptosis, patients tense the frontalis muscle and tilt their head back to see better. When the cornea is covered by the eyelid, amblyopia may develop.

The differential diagnosis is based on the fact that congenital ptosis is often combined with paresis of the superior rectus muscle and epicanthus. Acquired ptosis is usually part of a symptom complex of general and local disorders. Sympathetic ptosis is usually small, unilateral and is accompanied by constriction of the pupil and enophthalmos (Horner's syndrome).

Treatment of acquired and sympathetic ptosis primarily involves treating the underlying disease. UHF therapy, galvanization, and paraffin therapy are used locally. If ineffective, surgical intervention is required.

Congenital ptosis can only be treated surgically. The results of operations are usually favorable.