Therapy
In the case of non-reversible ptosis, aging processes or in cases that have existed since birth, surgical correction of the eyelid is usually the main focus. In this treatment, the lower edge of the upper eyelid is raised by removing a piece of the eyelid or eyelid muscles and then suturing. Folding and suturing of the subsequently shorter lid muscles is also possible.
In more severe cases, an attachment to the forehead muscle is also conceivable, after which the patient can control the eye opening by frowning. As a non-surgical therapy, there is the option of bridge glasses, which prevent the eyelid from slipping down with their specially adapted bridge. Ultimately, many forms of ptosis focus on the treatment of the disease causing it, in which, depending on the severity of the nerve damage, the symptom of ptosis may also disappear again. In the case of more severe or longer lasting damage, however, the ptosis persists.
When is surgery necessary?
In ptosis, the eyelid hangs down. In most cases the upper eyelid hangs down only a little bit, so that vision is still possible and it is only a cosmetic problem. In rare cases, however, it can also happen that the upper eyelid hangs down so much that vision with the affected eye is no longer possible.
As a result, the affected person loses the possibility of 3-dimensional vision, which can lead to serious limitations in everyday situations, for example when driving a car. In this case, surgery is strongly recommended, as it can enable an unrestricted everyday life. In some cases, the cause of ptosis is not paralysis of the nerve, but a rupture of the eyelid lifter muscle, often as a result of an accident. The muscle can then be sutured back together in a minor operation.
Acupuncture – does it make sense?
The use of acupuncture for ptosis can be useful depending on the situation. The principle of this traditional Chinese treatment method is based on different pathways and energy bundles in the body. According to its hypothesis, the cause of ptosis is not only paralysis of the facial nerve (facial nerve paresis), but also disturbances in these energy channels.
By using small needles in acupuncture, an attempt is made to find and manipulate these pathways so that the energy bundles are strengthened again. In the case of chronic ptosis, where all treatment has failed, the additional use of acupuncture can be helpful. Nevertheless, acupuncture should only be used as an additional measure to the conventional medical treatment of ptosis.
Apart from the small possibility that, if the nerve damage does not last too long, the ptosis will also regress after the cause has been removed, the success of a necessary operation cannot be fully calculated. In addition to the usual surgical risks, there is the danger of under- or over-correction of the eyelid, as is the case with many plastic surgery procedures. As a result, the ptosis either persists, albeit to a lesser extent, or the eyelid closure of the eye is no longer completely possible.
In this case, eye drops must be used regularly to prevent the eye from drying out. Special precautions should be taken at night during sleep and further surgery may be necessary for correction.
