Ptosis refers to drooping upper eyelids which can be present from birth (congenital) or develops later in life (acquired). This can lead to a restricted visual field, eye strain, brow ache and fatigue. It can also give a tired appearance to the face. Mr Yadav is an oculoplastic surgeon who specialises in all forms of ptosis correction.
What causes ptosis?
Ptosis may be present at birth (congenital) or can appear later in life (acquired). Congenital ptosis is usually due to a defect in the muscle responsible for elevating the eyelid (levator muscle). This can lead to a problem in visual development as the child may not be able to see as well from the affected eye. Occasionally the problem may be purely cosmetic with no interference in visual development.
Acquired ptosis usually develops as a result of ageing. Less common causes include nerve injury, autoimmune conditions like myasthenia gravis, mechanical forces on the lid like large cysts, long-term contact lens wear and after eye surgery such as cataract.
How is ptosis assessed?
During you consultation, Mr Yadav will assess the function of your eyelids and rule out any reversible causes of ptosis. He will also perform a full eye examination. Surgery is permanent and must be carefully planned to avoid over- or under-correction.
What type of anaesthetic is used for ptosis surgery?
In children ptosis surgery is usually done under general anaesthetic (asleep) as they are not mature enough to cooperate while awake. In adults, the preferred method is performing surgery under local anaesthetic. This allows the eyelid height to be assessed and adjusted accordingly during the surgery by asking you to open your eyes.
How is ptosis surgery performed?
The type of surgery performed is dependent on the findings during your consultation. The main factor is how well your levator muscle functions. If there is enough residual function then this muscle or its tendon is reattached to the eyelid using deep buried dissolvable stitches. If there is very poor levator muscle function, the eyelid is suspended from the brow to elevate it using artificial material buried beneath the skin.
What happens after ptosis surgery?
A pressure pad is placed over the eye to minimise the bruising and swelling. This may be removed in an hour or left for a day depending on the surgery. After the pad is removed, it is important to take measures to speed up recovery. You will be given ointment to apply to the surface of the eyelid and dry eye drops to instil in the eye for 2 weeks. You are advised to apply ice-packs over the closed eye and sleep more upright for a few days.
What are the risks of ptosis surgery?
As with all surgery, there are risks associated with ptosis correction and unexpected outcomes do occur due to how the body heals. The main risks are over-correction (the eyelid ends up too high) and lagophthalmos (an inability to close the eye). These are both very rare as Mr Yadav will check the height of your eyelid and fine-tune it during surgery.