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Ptosis Surgery

Ptosis Surgery 

“The secret to staying young is to live honestly, eat slowly and lie about your age.”
- Lucille Ball

….and maybe take a little help from medical science! You can’t defy aging and its effects. Drooping eyelids are one of them. But an Eye Surgeon can definitely help you tackle your drooping eyelids. Here’s how…

What is Ptosis?

Ptosis is the condition where your upper eyelids droop either because of aging (weakness of the muscles that support your eyelids) or diseases or because you had it at birth. It can affect one or both your eyes. It can even hamper your vision.



What is Ptosis Surgery?

It is a surgery that is done for the repair of droopy eyelids. It involves the removal of excess skin, fat and muscle. Blepharoplasty is the surgical repair of an eyelid and it includes not only ptosis surgery, but also cosmetic surgery to treat droopy lower eyelids, bags under your eyes etc.
Ptosis Surgery is usually done on an outpatient basis, meaning that you need not be hospitalised over-night.

Why is it done? (Indications)

To elevate a drooping upper eyelid that is interfering with your vision so much as to disrupt daily activities.

In children, it is usually done by 5 years of age unless the ptosis is very severe in which case; it is done shortly after birth.

Cosmetic purposes

What are the Contra-indications?

You cannot undergo a Ptosis surgery if you suffer from:

Loss of the blink reflex or sensitivity in your cornea

Significant dry eye (An inflammatory condition in which there is inadequate production of the tear film)

Paralysis of your orbicularis muscle (A muscle that closes your eyelids)

What is the preparation before this surgery?

Your doctor will perform the following tests prior to surgery:

Visual acuity testing (to see if your ptosis has caused any amblyopia or lazy eye)

Visual field testing, Refraction Studies and Tear Function Testing

Orthoptic Evaluation (to look for any other problems that need to be corrected along with your ptosis)

Ptosis Measurements that include evaluating levator (the muscle that lifts your eyelids) function, upper lid height etc.

CT Scanning of the eye socket may be done if any abnormality is suspected in the socket.

You will be asked to stop certain medications prior to surgery

Arrange for someone to accompany you home after the surgery because your vision might be impaired.

Your eyes may be photographed from different angles to plan out your surgery.

How is the surgery performed?

General anaesthesia is given to children, which means that they are sleeping throughout the surgery. For adults, a local anaesthesia is given which benumbs the eye.

A cut is made on the skin of the upper eyelid, usually where the crease of your eyelid is. This helps in hiding the scar. Excess skin and fat below the skin are removed. The levator muscle aponeurosis (A broad attachment of the muscle to the eyelid) is tightened using stitches.

Alternatively, a muscle from your forehead (called the frontalis) can be used to lift your eyelid. This is done by attaching a sling of tissue from your forehead muscle to your eyelid. This operation is called a frontalis sling or brow suspension.

The cut is then closed with tiny stitches which leave a nearly invisible scar. Some surgeons may use surgical adhesive tape instead.

What are the precautions I need to follow after the surgery?

Avoid straining, heavy exercises and strenuous activities.

Wear sunglasses to protect your eyes from the sun and wind

Sleep with your head slightly raised.

Follow the instructions given to you regarding eye drops and other medications.

What are the risks? (Complications)

Complications are rare but occasionally these may be seen:
Infection of eyes
Asymmetry between the two eyes
Irregularities of lid shape
Over correction or Under correction which would require a repeat surgery
Dry eyes with irritation
Temporary change in vision like double vision
Temporary numbness of the skin over the eyelid 
Impaired functioning of the eyelid
Scar formation
Injury to eye muscles

What can I expect after the surgery?

An ointment may be applied to your eyes to prevent dryness. Your eye may be patched for 24 to 48 hours.

You may experience swelling, puffiness of eyelids and bruising which may last a week. Ice packs can help reduce this.

Pain is usually minimal for which you can be given pain relievers.

Scars may take six months or longer to fade.

It may take about 3 – 6 weeks for the full effects to be apparent, sometimes taking 3 – 6 months.