Ptosis: Symptoms, types, Diagnostics and treatment

Published At: 17 January 2020 , 03:52 PM

To accurately determine what to do in a particular case, how to remove ptosis, whether treatment without surgery is possible, several studies can be carried out:

Ptosis is a disorder in which the upper eyelid drops, resulting in partially or entirely blocking the eye. This condition is also called blepharoptosis. There are several reasons why the disease requires treatment. This is an aesthetic defect, since the eyes are not the same size, and - ptosis can lead to visual impairment due to the banal mechanical interference with vision.

Types of Ptosis

Distinguish between congenital and acquired ptosis of the upper eyelid.

Acquired ptosis of the eye occurs for various reasons:

• Muscle fatigue, myogenic disturbance. To identify it, the use of drugs with endorphin is used, for the duration of which the problem disappears. 

• Neurogenic. It occurs due to paralysis of the oculomotor nerve. Destructive neurological processes can be caused by infections, multiple sclerosis, stroke, strangulation of the cervical nerves, neuropathy. 

• Loss of muscle elasticity. It develops due to age-related factors or post-traumatic changes. 

• Mechanical reduction in muscle length, scars after the trauma that physically prevent the eyelid from performing its functions. Such an omission of the eyelid is mechanical ptosis. 

• The false or visual omission of the upper eyelid, which is due to the presence of skin folds.

• Aponeurotic - due to age-related changes, and is also the result of plastic surgery. 

• Gravitational ptosis - develops with age in women and men. Usually, due to a decrease in muscle tone of the face.

Congenital manifestations include:

• Genetically determined ptosis of the century. The muscles of one or both eyes in the newborn do not develop enough, can be shortened or weak. 

• Neurological disorders, intrauterine pathologies and birth injuries - can also be the cause of the pathology.

Ptosis location

Separate the unilateral prolapse of the upper eyelid and bilateral. Thus, ptosis can be left-sided, right-sided, or mutual.

Congenital ptosis often affects both eyes. Also, bilateral can be acquired forms of the disease, for example, age-related, aponeurotic and others.

Degree of eyelid drooping

Classification by the degree of omission of the eyelid disease is divided into:

• Partial - no more than a third of the pupil is blocked (1 degree). 

• Incomplete - the eyelid reaches the centre of the pupil (2 degrees). 

• Full or pronounced - complete pupil overlap (3 degrees).

Symptoms of ptosis of the upper eyelid

The omission of the upper eyelid is the main symptom of ptosis in children and adults. With a partial or complete closure of the eyelid gap with the eyelid, the patient tries to raise the descending eyelid with the forehead muscle. Thus, the eyebrows raised. Also, patients tend to throw their heads back, taking the so-called "stargazer pose". Patients experience eye fatigue because blinking movements not fully completed.

Features of ptosis in children

The main complicating factor in a child's disease is the impossibility of early diagnosis. It isn't effortless to make a diagnosis because the child sleeps a lot. It is essential to identify the problem at an early stage, carefully observing the possible signs of eyelid ptosis. In the first months of life, a violation can be manifested by frequent blinking and eye irritation. In older children, the diagnosis of ptosis is straightforward.

Symptoms of the problem -

• The child throws back his head while reading, writing. 

• Muscle contraction on the part of the lesion. 

• Complaints of fatigue and irritation in the eye area.

Congenital pathology may be accompanied by disorders such as strabismus, epicanthus, damage to the cornea, and decreased vision.


As a rule, an examination is sufficient to make a diagnosis. Determining the degree is to calculate an indicator equal to the distance between the pupil and eyelid. To accurately determine what to do in a particular case, how to remove ptosis, whether treatment without surgery is possible, several studies can be carried out:

• Determination of visual acuity and fields. 

• Measurement of intraocular pressure. 

• Study of the condition of the fundus. 

• Biomicroscopy. 

• Carrying out MRI and CT of the brain.


You can start treatment of ptosis of the upper eyelid only after a complete diagnosis. Various methods of eliminating the problem used, both surgical treatment and correction without surgery. The possibility of removing ptosis depends on the degree of violation, the characteristics of the body and the age of the patient. Also, do not forget about prevention. After all, preventing a violation is much easier than curing.