A sagging or drooping eyelid is described in medical terminology as palpebral ptosis—palpebral refers to the eyelid. Patients with this condition appear to have one or both eyes fully or partially closed. This disorder may be present at birth or acquired throughout the life course. Surgery is the typical treatment for palpebral ptosis, but options vary depending on the cause and severity of the disfigurement.
This condition occurs when the levetor muscles that control the eyelid fail to function correctly. Most cases of palpebral ptosis are observable in only one eye, though it is possible for both eyes to be affected. People with this condition suffer from restricted vision, headaches, and dissatisfaction with the physical deformity. In some cases, people with palpebral ptosis may compensate for visual limitations by elevating their chins and gazing downward. This posture can cause stress to neck muscles over time.
In cases where the condition developed after birth, physicians may consult photographs to determine when symptoms began and chart how the disfigurement has progressed. Acquired palpebral ptosis is sometimes part of the natural aging process, or it can occur along with a cataract. It also may be the result of surgery or physical trauma to the eye and surrounding muscles. In rare cases, added weight from a growth or tumor in the area may cause the eyelid to sag.
If the palpebral ptosis is congenital in nature, it may or may not be noticeable at birth. Symptoms are usually observed before the child's first birthday. Patients who are born with this disfigurement often have malformed muscle tissues in the eyelid or fatty deposits that lack elasticity. Although this condition may be the result of trauma at birth, infants and children who display signs of palpebral ptosis should be thoroughly examined for other chromosomal disorders.
Palpebral ptosis will not correct itself over time without intervention. Early treatment is important, because children with congenital forms of this condition may have developmental delays as a result of their limited vision. Attempts to compensate for this abnormality may result in damage to the neck or spine. Corrective surgery should be completed within the first five years of life.
Corrective surgery for palpebral ptosis may be cosmetic or functional in nature. The procedure, sometimes called blepharsoplasty, usually shortens or strengthens the muscles that control the eyelid. In rare cases, the muscles may be too weak for repair, and the surgeon will correct the problem by attaching the eyelid to the brow muscles. Surgery for this condition is relatively delicate, as palpebral ptosis may be over-corrected. This results in the inability to close the eye fully or paralysis of the eyelid.