Ptosis
Introduction
The word Ptosis comes from Greek, meaning “falling” or “drooping.”
Simple word – Failure to open eye Lid
In medicine, Ptosis refers to drooping of the upper eyelid.
It can affect one eye (unilateral) or both eyes (bilateral).
If severe, it can even block vision.
Causes of Ptosis
Ptosis can happen due to problems with the muscles, nerves, or skin of the eyelid.
Common causes:
Congenital Ptosis Present since birth. Caused by weak or poorly developed eyelid muscle (levator palpebrae). Acquired Ptosis (develops later in life) Age-related (senile ptosis): Muscle becomes weak with aging. Neurological causes: Nerve damage (3rd cranial nerve palsy, Horner’s syndrome). Trauma or injury: Eyelid muscle or nerve injury. Myasthenia Gravis: Autoimmune disease causing muscle weakness. Mechanical causes: Tumor or swelling making eyelid heavy.
Types of Ptosis
Congenital Ptosis – since birth. Aponeurotic Ptosis – due to age or repeated eyelid rubbing. Neurogenic Ptosis – nerve damage (e.g., 3rd nerve palsy). Myogenic Ptosis – muscle weakness (e.g., myasthenia gravis). Mechanical Ptosis – extra weight on eyelid (tumor, swelling).
Symptoms
Drooping of one or both upper eyelids. Eye strain or tired eyes. Head tilting backwards to see clearly. Double vision (sometimes). In children: risk of lazy eye (amblyopia).
Diagnosis
History and examination of eyelid position. Visual acuity tests (to check effect on vision). Neurological tests if nerve problem suspected. Imaging (MRI/CT) in trauma or tumors.
Treatment
Depends on the cause and severity:
Observation – Mild cases that don’t affect vision. Glasses with special crutch – To support eyelid in mild ptosis. Medications – For underlying conditions (e.g., myasthenia gravis). Surgery (Ptosis repair / Levator surgery) – Main treatment to lift eyelid.
Complications
Permanent vision problems in children (amblyopia). Eye strain and headache. Cosmetic concern and reduced confidence.
Nursing Care Tips
Educate patient/parents about regular eye check-ups. Watch for signs of amblyopia in children. Supportive care after surgery (eye drops, hygiene). Encourage use of protective glasses if vision is affected. Provide emotional support as cosmetic appearance can affect confidence.
Interesting Fact
Ptosis is sometimes mistakenly thought to be just “sleepy eyes.” But in reality, it may signal serious neurological conditions like nerve palsy or myasthenia gravis.