Ptosis of an upper eyelid

Description:

The ptosis of an upper eyelid  (from Greek ptosis - falling) is a blepharoptosis below the upper edge of an iris more than on 2 mm (ideally the edge of an upper eyelid approximately on 1,5 mm closes an iris), or below other century, when comparing both eyes.

Symptoms of the Ptosis of an upper eyelid:

The ptosis of an upper eyelid occurs rather often, both at adults, and at children, and, the state it can be inborn, and can develop during life because of stretching and thinning of an aponeurosis of the muscle raising an upper eyelid. Also the ptosis of a century can appear at any age as a result of an injury of an upper eyelid or a disease of an eye.

Kinds of a ptosis
- Unilateral or bilateral
- Inborn or acquired
- Full or not full

The ptosis is classified by degree of manifestation:
- the 1st degree – an upper eyelid blocks an upper third of a pupil;
- the 2nd degree – an upper eyelid blocks upper 23 pupils;
- the 3rd degree – an upper eyelid completely closes a pupil.

At big degrees of a ptosis sight in the affected eye can gradually decrease to its total absence. The frequent phenomenon at a ptosis is squint or an amblyopia. Children usually try to compensate a ptosis, straining muscles of a forehead or throwing back the head.

Patients with the acquired ptosis have more elastic and elastic muscle raising an upper eyelid and usually can close an eye at the look lowered down. Incomplete closing of an upper eyelid, at most lowered look and the small amplitude of movements of an upper eyelid can be the important help in differentiation of an inborn ptosis of a century. The inborn ptosis of an upper eyelid more often happens unilateral, acquired - arises from two parties more often.

The most frequent manifestation of a ptosis is the lowered eyelid. Depending on expressiveness of this omission this or that degree of a vision disorder can be noted. Sometimes such patients bend the head back better to see, or sharply raise eyebrows to raise the lowered eyelid.

Extent of omission at a ptosis varies at different people. Among other manifestations of a ptosis it is possible to note such as:
- Irritation of eyes,
- Impossibility of full closing of an eye,
- Fatigue of eyes because the patient is forced to hold constantly their open,
- Children can incline the head back to raise an eyelid,
- Strabismus (squint),
- Doubling in eyes.

Reasons of the Ptosis of an upper eyelid:

- The underdevelopment or lack of the muscle raising an upper eyelid is the reason of an inborn ptosis.
- The outcome of some diseases (neuritis of a third cranial nerve, encephalitis, etc.) leading to paresis or paralysis of the third cranial nerve innervating the muscle raising an upper eyelid is the reason of the acquired ptosis.

Treatment of the Ptosis of an upper eyelid:

Treatment of a ptosis of an upper eyelid is carried out by means of operation, in a case with an inborn ptosis, the muscle directed to shortening raising an upper eyelid, in a case with the acquired ptosis, directed to shortening of the stretched aponeurosis of this muscle.

Operation on correction of a ptosis of an upper eyelid
Operation at correction of a ptosis of an upper eyelid can be performed as under local anesthesia, and under anesthetic and lasts of 30 minutes till 1 o'clock.

During operation at the acquired ptosis on an upper eyelid the thin strip of skin is removed, the orbital partition is cut, under it the aponeurosis of the muscle raising an upper eyelid is cut, the aponeurosis is shortened and hemmed to a tarzalny plate (a cartilage of a century) slightly lower.

At the end of operation the wound is taken in by a continuous cosmetic suture. Operation on correction of a ptosis of an upper eyelid can be carried out together with a blepharoplasty.
During operation on correction of an inborn ptosis of an upper eyelid the small strip of skin is also removed and the orbital partition is cut. The muscle raising an upper eyelid on which put several stitches is accurately excreted, for the purpose of its shortening (muscle plication is carried out), and the wound is taken in by a continuous cosmetic suture. In cases of strongly expressed inborn ptosis the century, the muscle raising an eyelid can be hemmed to a frontal muscle.

After operation on correction of a ptosis
After operation on correction of a section of eyes the bandage which usually is removed in 2-4 hours is applied eyelids. Pain is usually not expressed and most of patients do not need reception of analgetics. Seams from skin around eyes are removed for the third or fifth day after operation. The hypostases and bruises arising after operation usually pass within 7-10 days. The esthetic result usually remains for the rest of life.