Blepharoptosis: Eyelid Droop, Causes & Treatment

Blepharoptosis, or drooping of the eyelids, is a condition that can be caused by a variety of causes, either genetic or acquired. In detail:

1. Congenital Blepharoptosis: it is a condition present from birth and is usually due to abnormalities of the levator muscle, which is responsible for opening the eyelid. This abnormality can affect the muscle's ability to function properly, causing drooping in one or both eyelids.
2. Acquired Eyelid Droop: Occurs later in life and can be caused by multiple factors:

• Aging: The most common cause is aging, where the tendon that connects the levator muscle to the eyelid can become loose or displaced, causing a droop.
• Neurological problems: Disorders in the nerve that controls the levator muscle can cause eyelid droop, as the nerve cannot transmit nerve signals properly.
• Myopathies: Certain muscle diseases, such as myasthenia gravis, can cause weakness in the facial muscles, including the levator muscle, affecting the ability of the eyelid to remain in an elevated position.

Each case of blepharoptosis requires a detailed clinical evaluation to determine appropriate treatment. Procedures vary from minor adjustments to more complex surgical procedures, depending on the cause and extent of the blepharoptosis.

Blepharoptosis or Blepharoplasty

Blepharoptosis and blepharoplasty are two procedures with certain similarities but also important differences:

1. Blepharoplasty: This procedure removes excess skin from the upper eyelid, creating a crease that gives the eyes a more youthful and rested appearance. Blepharoplasty focuses primarily on aesthetic improvement of the area around the eyes.
2. Blepharoplasty : This procedure focuses on functional improvement by tightening or shortening the muscle responsible for opening the eyelid. It aims to improve the patient's vision that may be affected by the drooping of the eyelid.
3. Combination Therapy: In cases where the patient has significant skin laxity and weakness of the eyelid muscle, blepharoplasty and ptosis repair may be combined to achieve both functional and aesthetic improvements.
4. Role of Physician: The decision on which procedure is most appropriate should be made by a plastic surgeon who will evaluate the patient's needs and circumstances.

Patients should discuss at length with their surgeon their expectations and desires for the outcome of the surgery, and the physician should provide detailed information about the benefits, potential complications, and the recovery process.

Symptoms of Blepharoptosis

Blepharoptosis, or eyelid drooping, may not manifest immediate symptoms in the early stages, but as it progresses, its effects become more noticeable, significantly affecting the patient's daily life. The main signs that may be observed include:

1. Decreased Peripheral Vision: the protruding eyelid may cover part of the visual field, especially on elevation of the gaze. This is often more obvious when driving, reading or using a computer, making these activities more difficult and potentially dangerous.
2. Fatigue and Pain: The constant need to elevate the eyebrows in order to improve vision can cause fatigue and pain in the forehead and eyebrows. Patients often report a feeling of heaviness in the eyelids and pressure on the forehead.
3. Headache: Trying to keep the eyelids in an open position can lead to frequent headaches, particularly in the area around the eyes and forehead.

The diagnosis and treatment of eyelid ptosis requires a thorough medical evaluation, as the signs and causes may vary from case to case. In most cases, the choice of surgical treatment depends on the severity of the condition and the extent to which eye function is affected.