About Ptosis
Ptosis (drooping of the upper eyelid) causes narrowing of the visual field and can alter facial expression. It may affect one or both eyelids; in mild cases it is mainly a cosmetic concern, while severe ptosis can cover the pupil and limit vision.
Congenital ptosis seen in childhood may lead to amblyopia and usually requires early assessment and management. In adults, age‑related aponeurotic changes, levator weakness, neurological disease or trauma can cause ptosis. With proper timing and careful surgical planning, both functional and aesthetic results can be achieved.
What is Ptosis?
Ptosis occurs when the muscles that elevate the eyelid (the levator complex and Müller muscle) are weak or damaged. Patients often compensate by raising their eyebrows or tilting the head back. Ptosis can cause eye strain during reading, dry eye symptoms and headaches from the extra effort to maintain vision.
Congenital Ptosis
Results from underdevelopment of the levator muscle and may require early intervention to prevent amblyopia in children.
Edinilmis Ptosis
Can arise from aponeurotic dehiscence with aging, neurologic disease such as myasthenia gravis, trauma or prior eyelid surgery; treatment addresses both the eyelid and any underlying cause.
Symptoms and Diagnosis
Common Complaints
- Upper eyelid partially or fully covering the pupil
- Raising the brows or tilting the head to see better
- Reduced visual field, difficulty when looking up
- Increased eye fatigue and occasional blurring by the end of the day
- Noticeable asymmetry and cosmetic concern in unilateral cases
Diagnosis Methods
Slit‑lamp examination, measurement of MRD1, levator function testing and, when indicated, neuroimaging are used. Children should have refractive assessment and amblyopia screening as needed.
Treatment Over time
Vision aksini kapatan or patient hayat quality dusuren ptosis in cases surgical planning geciktirilmez.
Causes & Risk Factors
Congenital Ptosis
Due to underdevelopment of the levator muscle or abnormal innervation, congenital ptosis may occur. In children it can cause abnormal head posture and a risk of amblyopia, requiring early intervention.
Aponevrotik / Senil
Ageing, prolonged contact lens wear or prior eyelid surgery can cause aponeurotic dehiscence, leading to eyelid droop.
Neurogenic & Myogenic
Disorders such as myasthenia gravis, third nerve palsy or Horner syndrome may accompany ptosis. Management should address any underlying condition alongside surgical planning.
Trauma & Mechanical
Eyelid tumors, scarring or heavy eyelids may produce mechanical ptosis. In post‑traumatic deformities, reconstructive surgical planning is required.
How is Ptosis Surgery performed?
Planning & Measurement
MRD1, levator function and lid symmetry are assessed to determine the most appropriate surgical approach.
Muscle Intervention
Levator resection, Müller muscle plication or an autologous/synthetic sling may be used to elevate the eyelid while preserving a natural lid crease.
Recovery and Follow-up
Cold compresses, prescribed drops and follow‑up appointments reduce swelling; minor adjustments to eyelid height may be made during follow‑up when necessary.
Restored visual field and balanced facial harmony
Which method is suitable for you?
After evaluating muscle strength, skin thickness, and ptosis severity, the safest surgical approach is selected.
Levator Resection
Shortening the levator aponeurosis allows precise adjustment of lid height and is the preferred choice when levator function is adequate.
- Preserves a natural lid crease
- Allows intraoperative symmetry adjustments
Frontal Suspension
When levator function is poor, the eyelid may be elevated by suspending it to the frontalis muscle, providing a durable, stable result.
- Long duration stable outcome
- Cesitli lift materyalleri options
Müller Muscle Plication
For mild ptosis, a posterior approach tightening the Müller muscle provides quick recovery and minimal swelling.
- Short surgery duration
- Eye dryness risk reducing approach
Postoperative Care
Apply cold compresses regularly during the first 48 hours; use prescribed antibiotic and anti‑inflammatory drops to reduce infection risk and swelling. Elevate the head while sleeping and avoid strenuous activity until your surgeon clears you.
- Follow‑up visits monitor eyelid height and allow suture adjustments when necessary.
- If the eyelids do not close completely at night, use a lubricating ointment and protective measures as advised.
- Avoid makeup and contact lens use until cleared by your doctor.
- If you have systemic conditions such as myasthenia gravis, continue systemic treatment under specialist supervision.
Most patients adapt to the new lid position within a few weeks and regain a stable visual field.