Ptosis, also known as ptosis, is what medical professionals call a visible drooping of one or both upper eyelids. Basically, ptosis is only a symptom and can have various causes. It may either resolve itself if the cause is treated or may require surgical correction.
What is ptosis?
Ptosis, also known as ptosis, refers to a usually clearly visible drooping of one or both upper eyelids. Ptosis, also known as ptosis, refers to a usually clearly visible drooping of one or both upper eyelids. This may be complete or only partial, and thus in some cases may impair the vision of the affected person. In principle, the term ptosis can also be used to describe the drooping of other organs or parts of the body, such as the female breast. However, the use of the word has become predominantly for drooping of the upper eyelids. If the lower limbs droop, this condition is called ectropion. Ptosis itself is not a disease, but only a symptom, and thus can have quite different causes.
Causes
The reasons for eyelid ptosis may be, for example, a congenital malformation of the muscle responsible for eyelid movement (this is called levator in technical language). Such damage is hereditary and usually affects only one eye. The levator can also be damaged by advanced age or violence in the area of the eyes to the extent that the upper eyelid can no longer be lifted completely. Not only the levator itself, but also the corresponding nerve can be damaged, causing ptosis. In this case, the lowering of the eyelid is usually also accompanied by a visible squint. Certain muscle diseases, such as myasthenia gravis, can also cause temporary ptosis to develop.
Diseases with this symptom
- Stroke
- Myotonic dystrophy
- Encephalitis
- Myasthenia gravis pseudoparalytica
- Meningitis
- Miosis
Diagnosis and progression
Ptosis can usually be diagnosed by the attending physician without much effort, as it is visible at first glance. Greater importance should be given to determining the actual cause of drooping of the eyelid. Blood tests can provide information as to whether poisoning is present. Tumors or other damage to the muscles or nerves involved can be visualized with the help of a computer tomography. The physician can also determine whether and to what extent the levator is damaged by means of a muscle function test. Ptosis itself poses no danger to the health of the affected person; however, the untreated course of certain underlying diseases accompanied by ptosis can become life-threatening under certain circumstances.
Complications
Drooping of one or even both upper eyelids of the eyes has a very disfiguring effect. In daily life, this asymmetry between the eyelids not infrequently leads to psychological stress. The affected person withdraws more and more from the public, develops in some cases depressive signs up to depression. Congenital ptosis is usually detected at an early stage. However, if this is not the case, there are further complications. As a consequence, amblyopia, which is known as defective vision, develops. In order to prevent this danger, it is essential to consult an ophthalmologist, especially in the case of defective vision or strabismus in childhood. Ptosis often requires surgical intervention under local or general anesthesia. This can lead to nerve injuries, bleeding and infections. Furthermore, wound healing disorders and scarring are possible. In spite of the generally good prognosis, sometimes an insufficient effect (undercorrection) can be seen immediately after the operation. Ptosis is thus still present. If, on the other hand, the effect is too strong, the eyelid can no longer close. The eye dries out and allows ulcers to form in the cornea. In both cases, further surgical intervention is necessary. Ptoris itself is not a health hazard for the affected person.However, if this remains untreated as it progresses, the development of certain underlying diseases can take on a life-threatening state.
When should you see a doctor?
If the eyelid suddenly begins to droop, emergency medical services should be contacted immediately. The discomfort could be due to a stroke. Also, if the eyelid gradually begins to droop, the cause of this should be investigated by a doctor. The first way leads either directly to the ophthalmologist or to the family doctor, who usually issues a referral. Due to the many different forms of ptosis, a visit to the doctor is generally advisable in order to be examined and treated quickly and professionally. A prevention against ptosis is not possible, because ptosis is always caused by other basic diseases or a general damage of the eyelid muscle. Thus, it can only ever be investigated what caused the ptosis. To counteract the adverse effects of ptosis, homeopathy offers various solutions. Also, in the case of congenital ptosis, the surgical intervention should be performed as early as possible (approximately at the age of 3 years) to give the eye the opportunity to correct the visual performance.
Treatment and therapy
Exactly how ptosis is treated depends primarily on the cause responsible for drooping of the eyelid. Congenital ptosis can only be corrected with the help of a surgical procedure in which the eyelid is corrected and the muscle is shortened, for example. In this way drooping is prevented. Such surgical correction is also necessary if the levator is irreparably damaged by other causes. Under certain circumstances, surgical intervention on the eyelid can result in the eye no longer being able to close completely. This can lead to discomfort, especially at night. Then eye drops must be used regularly to prevent the eye from drying out. If the ptosis is due to a tumor disease, for example, this is treated with appropriate chemotherapy. In addition, surgery to remove the tumor may also be performed. Myasthenia gravis can be treated with medication so that the symptoms subside completely and the ptosis also resolves on its own. The latter is always the case if there is (still) no permanent damage to the muscles or nerves.
Outlook and prognosis
In ptosis, the prognosis is usually positive. If the symptom is congenital, it is usually sufficient to surgically lift the drooping upper eyelid. If the symptom is acquired, the prognosis depends on the cause. If a severe disease such as myasthenia gravis is present, the eyelid malposition may resolve on its own. After a few months, the ptosis can then be treated surgically, provided that the underlying condition has healed completely. In mild cases, so-called ptosis glasses, which lift the drooping eyelid, are sufficient for treatment. The prognosis is worse in cases of ptosis resulting from a stroke. The eyelid can be surgically repositioned, but other accompanying symptoms of the stroke can worsen the prospect of a full recovery. The prognosis may also be more negative for ptosis secondary to nerve or muscle disease; for example, if the underlying condition repeatedly causes one or both eyelids to droop. Because of the variety of possible causes, the final prognosis for ptosis can only be made by a treating physician.
Prevention
Since ptosis is only a symptom and not an actual disease, and may also be hereditary or age-related, prevention in the true sense is not possible. However, if the first signs of ptosis appear, it is advisable to consult a doctor in order to determine the exact cause of the eyelid drooping. Only in this way can any more serious underlying diseases be ruled out or treated appropriately at an early stage.
What you can do yourself
If ptosis is suspected, medical clarification is recommended. If the eyelid hangs suddenly, the emergency services should be alerted, because it is possible that a stroke underlies the symptoms. Also, if the eyelid begins to droop gradually, the cause should be clarified by a doctor. In addition, the affected eyelid can be temporarily fixed with special adhesive strips from the pharmacy.In addition, a diary should be kept in which notes are made about when the symptom began and which factors intensify it. Other complaints and abnormalities should also be recorded. Another recommended self-measure is the Simpson test. In this test, those affected must look directly upwards for about one minute. If the upper eyelid then drops slowly, ptosis is very likely to be present. Until surgery is performed, patients can wear so-called ptosis glasses, which raise the drooping eyelid and prevent the symptoms from progressing. In addition, the eyes and especially the affected eyelid should be spared until the surgical intervention. After surgery, it is sufficient to rest and cool the eyelid so that the surgical scar can heal.
