- AGE - This is the most common cause of ptosis. The muscles that elevate the eye stretch and became thinned as we age, resulting in a loss of muscle tone and an inability to raise the upper lid well. Ptosis affects both eyes, but often one eye appears worse than the other. Eye surgery, such as cataract removal, may aggravate this condition.
- CONGENITAL - Noticed at birth or shortly thereafter, congenital ptosis is produced by a developmental abnormality in the muscles that elevate the upper lid. Three-quarters of the time it affects only one eye.
- INJURY - Automobile accidents in which passengers are hurled through the windshield often damage the delicate structures around and in the eye. Lacerations, burns and chemical injuries may also cause this droopiness.
- NEUROLOGICAL DISEASES - These are rare but must be diagnosed properly to avoid unnecessary surgery until the timing is right.
Symptoms are functional as well as cosmetic. Difficulty reading and driving are common complaints. Raising the entire brow with the muscles of the forehead and scalp may cause headaches and eyestrain as well.
Treatment is surgical and there are a number of possible approaches. The goal is to elevate the lid to match the other side with a minimum of scars and side effects. The most discussed complication is over-doing it with resultant inability to close the eye completely after surgery. This creates a dry eye situation that may be difficult to manage.
In the age-related form, the unoperated eye appears to be too low after a successful repair of the first eye. This droopy appearance in the unoperated eye is to be expected. It also may require surgery.