Ptosis

 Ptosis

Ptosis is known as lazy eyes or dropping eyelids.

It causes due to weakness of orbicularis muscle responsible for raising eyelids, damage to facial nerve, loosening of skin of upper eyelids.

Types of Ptosis

1. Neurogenic ptosis

Oculomotor nerve palsy, Myasthenia gravis, Horner's syndrome (affects the one side of  face and eye), 

2. Myogenic ptosis

Ocular myopathy; limited elevation due to levator muscle weakness.

3. Mechanical ptosis

Due to edema or tumors of upper eyelid.

4. Pseudo ptosis

Lack of life support 

5. Aponeurotic ptosis/ senile ptosis

6. Neurotoxic ptosis

Neurotoxic ptosis is precursor to respiratory failure and eventual suffocation caused by complete paralysis of the thoracic diaphragm.

Clinical Manifestations

1. Dropping of eyes; Drooping of upper eyelids is most common.

2. Increased tearing or dry eyes

3. Interference with vision

4. Double vision

5. Eye and forehead fatigue

6. Difficulty in blinking or closing eyes

Management

1. Ophthalmic Plastic and Reconstructive Surgery

2. Surgical correction

Levator resection, Muller muscle resection, 

3. Children with ptosis, surgery is necessary to prevent amblyopia.

Ptosis if left untreated, can cause Amblyopia and Astigmatism.