Patients consider ptosis surgery when their upper eyelids are drooping, causing impaired vision due to the covering of the pupil. Additionally, droopy eyelids may not be aesthetically pleasing, and so patients may consider ptosis surgery for cosmetic reasons.
Droopy eyelids occur when there is a gradual stretching of the tissue that supports the lid caused by aging, long-term contact wear, or injury. Children may also experience droopy eyelids (congenital ptosis) due to hereditary factors or developmental issues in the levator muscle; their surgeries can be performed between the ages of 3-5 to promote proper visual development.
After a thorough examination, your ophthalmologist will gauge whether droopy eyelid surgery (ptosis surgery) is appropriate based on the patient’s ocular and medical history. Some patients require the levator muscle (eyelid muscle) to be tightened, while others with weak levator muscles may need frontalis (muscle below the eyebrow) suspension.
Treatment for adults and children with ptosis can differ; however, surgery will be required to treat most cases based on the type and severity of the symptoms. Some children who have ptosis may also have a lazy eye. If this is the case, special eyeglasses or an eye patch may be prescribed in addition to eye drops that can help to strengthen the weaker eye. For adults, there is a non-surgical option known as a ptosis crutch where an accessory is used in conjunction with eyeglasses to help hold the eyelid in place so it no longer droops.
The vast majority of both unilateral and bilateral ptosis affects predominantly the upper eyelids. However, on rare occasions, ptosis may be associated with significant systemic or intracranial diseases like Horner Syndrome, Oculomotor Nerve Palsy, or Myasthenia Gravis which can affect the lower lid and result in what we call reverse ptosis. This is a very rare condition where the lower lid will appear higher than normal.
When undergoing ptosis repair, patients are intravenously sedated while receiving local anesthesia and numbing eye drops to maintain optimum comfort levels. It is important for patients to have their eyes relaxed and closed for proper measurements. A small incision is made in the crease of the eyelid to maintain a natural appearance and hide any resultant scarring.
These procedures elevate the droopy lid, giving a symmetrical, aesthetically pleasing appearance while correcting for any vision interferences caused by the lid. The procedure takes about 45 minutes per eye.
Ptosis surgery is an outpatient procedure, but a friend or caregiver will need to drive the patient home afterward. Patients should not drive or partake in strenuous activity for the first couple of days. Eye drops and a lubricant will be given to keep the eyes from becoming dry or sore.
Here’s what you can expect in the weeks and months after ptosis surgery:
Eyelid ptosis is covered by insurance if it is considered medically necessary. If your insurance company denies the procedure as a medical necessity, there are cosmetic options available as well. In order to determine if you qualify for the surgery, we will need to submit the clinical and photos to your insurance company and allow 3-4 weeks for the preauthorization process.
To make quality care accessible to everyone, Milan Eye Center offers zero-down financing options with approved credit through Wells Fargo, CareCredit, and Alphaeon. We also accept all FSA/HSA plans.