Ptosis is a condition characterized by the inability to fully open the eye. The eyelid will appear low or droopy, potentially making the eye look smaller than normal.
This symptom occurs because the eyelid muscles do not function completely, resulting in partial eye opening, which can affect one or both sides. This visible droop of the upper eyelid covers more of the eye than usual.
A severely droopy eyelid can obstruct vision and affect the overall balance of the face. Ptosis can be found in children and adults of all genders and ages.
While it can be caused by daily lifestyle habits and other factors, ptosis may also impact an individual's confidence and personal appearance.
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Ptosis, or weak eyelid muscles, can easily lead to the following symptoms:
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Ptosis is caused by the weakness of the muscles specifically responsible for opening the eye. These muscles consist of two primary muscles that are layered and work in coordination to lift the eyelid: the Levator muscle and the Müller's muscle. This weakness can arise from several factors, which are listed as follows:
Congenital Ptosis is a condition where the levator muscle (the primary eyelid-raising muscle) is either underdeveloped or the ptosis is caused by hereditary factors. This results in a child being born with a drooping eyelid.
The droopy eyelid covers more of the eye than usual, leading to an incomplete opening of the eye. In cases where the muscle weakness affects only one side, the eye on that side may appear smaller or have reduced visibility compared to the other.
While the eyelid muscle itself remains present and strong, excessive and repetitive use over time causes the eyelid muscle to stretch as a person ages.
This stretching leads to sagging and drooping eyelids and a decrease in the firmness of the eyelid's main muscle. This loss of firmness may, in turn, cause a person to constantly raise their eyebrows or forehead as a compensatory action, which can ultimately lead to the development of wrinkles in those areas.
Certain daily habits and actions can contribute to this condition: excessive screen time and Contact Lens Use: Individuals who use computers or smartphones all day, as well as those who wear contact lenses regularly, are at risk.
Constantly rubbing the eyes or experiencing an injury/accident can cause the eyelid muscles to stretch or tear, which may lead to or worsen the ptosis condition.
A previous failed double eyelid surgery can lead to complications. For example, if the surgical procedure impacted the eye muscles, it may subsequently result in the development of ptosis (weak eyelid muscle) later on.
Myasthenia Gravis (MG) is a disease that affects communication between the nerves and muscles, causing the muscles to work below their capacity. Alternatively, the issue may stem from poor function of the third cranial nerve, which prevents the eyelid muscle from contracting fully. Both conditions lead to an inability to fully raise the eyelid.
Tumors or masses that compress the eye area.
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The most crucial first step is to accurately determine whether the primary problem is muscle weakness or skin drooping, before considering various treatment options. At Teeraporn, we treat the condition using surgical double eyelid procedures with muscle adjustment. This allows the surgeon to perform a detailed diagnosis to select the precise technique that will effectively address each individual's specific problem.
Teeraporn's surgical technique is a specialized double eyelid surgery with specific muscle adjustment. The doctors at TRP Hospital developed this advanced method to resolve ptosis by moving away from traditional long-incision surgery and adopting a technique called "Muscle Locking".
This method uses only a very small incision or sometimes just a pinpoint entry. Instead of the traditional cutting and suturing of the muscle, this new technique employs a "locking system" to directly anchor and adjust the weakened muscle layer. This advanced technique allows for the scar to be seamlessly hidden and delivers a more natural-looking result with the added benefit of no required hospital stay; patients can return home immediately after the procedure. The details of the specific locking techniques are as follows:
In this method, the incision is made on the inner surface of the eyelid. It results in minimal swelling and bruising. Crucially, no external scar is visible. The incision is closed using dissolvable sutures. This technique is specifically suited for patients with minor ptosis issues.
This technique involves an external incision with a short cut through the skin to reach and adjust the underlying eyelid muscle. The muscle is surgically corrected and positioned appropriately to create a beautiful, customized double eyelid crease.
Addressing Sunken or Hollow Eyes For patients who present with sunken or hollow eyes (enophthalmos), adding fat may be considered. This supplementary step can treat a range of conditions, from mild cases of muscle weakness to those with very significant muscle hypotonia.
This technique is appropriate for individuals with severe ptosis (weak eyelid muscle), typically cases that are congenital (present from birth). This complex procedure requires the expertise of a highly specialized surgeon and involves a longer operating time. The technique uses the forehead muscle to help lift the eyelid.
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The condition occurs because the levator muscle—the muscle responsible for lifting the eyelid—cannot function at full efficiency. This results in the eyelid only being able to open slightly, which impacts the patient's daily vision.
Correction involves deep surgical fixation at the level of the muscle. This procedure is often performed in conjunction with double eyelid surgery to help resolve the issues of a droopy, sleepy-looking eye (ptosis).
While eyelid muscle weakness (ptosis) is typically not severely dangerous, it significantly interferes with daily vision. Affected individuals frequently have to raise their eyebrows just to see, and this condition can also obstruct the visual field, limiting their view to a narrower angle.
If the patient undergoes proper and correct surgical treatment from a highly experienced physician, the eye will not droop again in the long term.
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It is important to note that this condition is not a serious disease, but it can significantly disrupt daily life. Patients often experience strain when looking up, have difficulty seeing clearly, and are forced to use their foreheads to assist with opening their eyes.
Precise surgical correction helps restore the eye to its ideal appearance, enabling the patient to see better. Furthermore, it serves to enhance the patient's self-esteem and confidence.
Choosing a hospital or clinic, along with a highly specialized surgeon, is crucial. This decision will help ensure that the problem is resolved and the patient receives the most suitable, targeted correction for the best possible outcome.
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