Ptosis of an upper eyelid

General characteristic of a disease

The ptosis represents a pathological blepharoptosis. At the same time at the patient the palpebral fissure and, respectively, a field of vision is partially or completely closed. Therefore the ptosis is not only cosmetic defect, but also a serious ophthalmologic disease. The ptosis of an upper eyelid can lead to a functional blindness.

The ptosis of an upper eyelid can be acquired or inborn. At children with an inborn form of a disease the ptosis is quite often combined with squint or an amblyopia (a disease of a lazy eye).

Treatment of a ptosis preferential surgical.

Reasons of a ptosis of an upper eyelid

Carry injuries or inborn defects which resulted in weakness of muscles or disturbances of neuromuscular transmission of an upper eyelid to the reasons of a ptosis. As the ptosis reason at children of early age the injury got by the child at the time of delivery, a neurofibroma (a nerve cover tumor on an upper eyelid) or a hemangioma (a tumor of blood vessels) can serve.

Among the reasons of a ptosis of the asymmetric bilateral slowly progressing form call a myasthenia (an autoimmune neuromuscular disease). The dystrophic myasthenia at the same time causes poverty of a mimicry and exhaustion of temporal muscles.

Oftalmoparez as one of the possible reasons of a ptosis on both eyes, leads to a symmetric form of a disease and weakness of a circular muscle of eyes.

The reasons of a ptosis of an upper eyelid of an acute form have, as a rule, neurogenic character. Omission of a century is quite often observed at Horner's syndrome (pathology of a sympathetic innervation). At this type of pathology the ptosis of an upper eyelid develops only on one eye.

The reason of a ptosis of a senile form – age changes in muscles of a century and sagging of the skin which lost the elasticity over a palpebral fissure.

Whatever ptosis reasons were, patients need consultation of the ophthalmologist.

Signs of a ptosis of an upper eyelid

The main symptom of a ptosis – omission of a century of one or both eyes. The patient with a ptosis of an upper eyelid cannot close completely eyes, and it leads to visual overfatigue and irritation of tissues of eye.

With a ptosis of an upper eyelid it is also heavy to patients to blink. Trying to expand a field of vision, they throw back the head back. Attempts to raise an eyelid hands can lead to infection of eyes of the patient. The inborn ptosis at children quite often proceeds against the background of squint, an amblyopia or a diplopia (sight doubling).

Diagnosis and treatment of a ptosis of an upper eyelid

Diagnosis of a ptosis is possible. For diagnosis height of a century is measured, symmetry and completeness of the movement of upper eyelids of both eyes are checked.

Treatment of a ptosis of an upper eyelid – surgical. Standard operation at a ptosis – shortening of a century by means of formation on it a so-called dublikatura of the levator. For this purpose on a century of the patient needing treatment of a ptosis three p-shaped seams are made.

This type of operation at a ptosis cannot be performed at patients with an inborn form of a disease as in this case the patient has, as a rule, too thin layer of muscle bulk of a century. Treatment of a ptosis of an upper eyelid with overlaying of a dublikatura of the levator quite often leads to eruption of seams and a recurrence of a disease.

Alternative operation at a ptosis of an upper eyelid – a technique of formation of a dublikatura of a tarzoorbitalny fascia. From above the called method of treatment of a ptosis it differs in way of strengthening of a fold of a century. Except three p-shaped seams this operation at a ptosis assumes use of diathermocoagulation (cauterization by diathermic current) covers of muscles of an upper eyelid.

Use of diathermocoagulation in treatment of a ptosis of an upper eyelid allows to reduce injury of operation, to improve the subsequent scarring of muscles of a century and to do without use of transplants during surgical correction of pathology.

Surgical treatment at a ptosis of an upper eyelid is carried out under local anesthesia. The exception is made by children: during operations at a ptosis at children use of the general anesthesia is recommended.