December 9, 2021
When the upper eyelid of the eye is drooping we speak of ptosis and ophthalmologist Filipa Ponces explains the origin of this problem:
To understand why ptosis appears, you need to know that the upper eyelid has a structure called the upper eyelid lift muscle, which is responsible for its elevation. It is made up of a fibrous part anterior to the aponeurosis which attaches to the eyelid, and a muscular posterior part which attaches to the orbital bone in the back.
If this muscle develops defectively, or if during life there is a problem with any of these components, ptosis can occur.
Ptosis can appear at any age and, if it appears at birth, we say it is congenital; if it occurs later, we say it is acquired, the latter being the most frequent in the population.
There are various types of ptosis. We speak of myogenic, aponeurotic, neurogenic or other types of ptosis. We can also classify it according to its severity into mild, moderate or severe, severe being that in which the visual axis is already compromised.
In children, ptosis usually occurs due to malformation of the levator muscle during pregnancy and manifests itself at birth, usually affecting only one eye. In an adult, ptosis is more associated with a detachment of the aponeurosis that typically affects both eyes and patients have sunken eyes with a characteristic sad look.
Mild ptosis does not cause symptoms and only has aesthetic consequences. If it is more severe, the patient may complain of eyelid heaviness or fatigue, poor vision and even cervical discomfort, especially if the chin is raised to compensate for the ptosis.
Treatment is usually surgical and consists of cutting the levator muscle, which will give it more strength. Or reinserting the aponeurosis, which normally leaves no marks or scars. Children are always operated on under general anaesthetic and adults usually under local anaesthetic or sedation. There is no ideal moment to perform the surgery, but in children, if there is a risk of compromised vision or if they have an abnormal position of the neck, they should be operated on quickly.
In adults it can be done at any time, either for aesthetic or functional reasons.
In tomorrow's programme, we will talk about eye discomfort in front of the computer.
With the support of the Portuguese Society of Ophthalmology.
