What is Ptosis?
Ptosis is a fairly common condition in which one or both of your upper eyelids droop so that the eyelid margin sags, crowding or even covering the pupil. The drooping can be to a small extent, or it can be substantial so that the eyelid actually inhibits your vision. In fact, if the drooping eyelid significantly interferes with your vision, your medical insurance may cover the surgery.
Some patients are born with ptosis and live with the condition for a long time, others have developed more recently as a part of the aging process or because of an injury. Either way, ptosis repair surgery could be the answer for you.
Causes of Ptosis
Ptosis is a common result of muscle weakness in the muscle used to raise the eyelid or the nerves that control that muscle. Additionally, ptosis can be simply caused by loose skin on the eyelid. However, the cause of ptosis can also be more troubling. In certain cases, ptosis can result from a congenital condition, injury, surgery, or one of the following:
- Bell’s palsy
- Benign or malignant tumor
- Growth in the eyelid, such as a stye
- Horner syndrome
- Migraine headache
- Myasthenia gravis
The drooping of one or both eyelids can present as increased tear production, difficulty blinking or closing the eye, or reduced vision as a result of severe drooping. Most commonly, since ptosis is caused by aging, the onset of symptoms is gradual. If patients experience a sudden onset of symptoms it is important to see Dr. Holds immediately.
Dr. Holds Discusses Ptosis
If you believe you have ptosis, you may benefit from ptosis repair in St. Louis with Dr. John Holds. As one of America’s “Top Docs” Dr. Holds has written and published extensively on the topic of ptosis repair and is a noted authority on the topic. Here, Dr. Holds explains ptosis and ptosis repair.
An ophthalmologist, such as Dr. Holds, can diagnose ptosis and often the cause of the problem. First, Dr. Holds will perform an eye examination including visual acuity tests, visual field testing, and a slit-lamp examination. In addition, Dr. Holds may choose a tension test for myasthenia gravis. After testing, if Dr. Holds finds that the drooping lid is a result of an underlying disease patients will be referred to another physician for further investigation.
Ptosis Repair Consultation
After diagnosis and determining the need for surgery, patients will need to come in for a pre-surgery consultation. After arriving at our office, patients will need to provide a medical history as well as a current list of medications. We need to know about any major illnesses or problems you have had prior to surgery. Certain medications or supplements you take may need to be stopped for a week or so prior to your ptosis repair.
Dr. Holds will discuss your surgical goals, talk about what is attainable, and create a plan to accomplish it. Additionally, he will ask you what bothers you about your eyelids and how these changes in your eyelids may relate to changes in other parts of your face. It is important to have reasonable expectations and a mutual understanding of goals. Finally, Dr. Holds will check for other eye conditions present that may alter the surgical plan.
Before and After Ptosis Repair
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Ptosis Repair Procedure
Ptosis repair is a surgical procedure that is performed on an outpatient basis. A local anesthetic is generally sufficient, although patients may opt for sedation in order to feel relaxed. Dr. Holds and his associates at Ophthalmic Plastic and Cosmetic Surgery, Inc. have extensive experience performing ptosis repair surgery and always take great care to make sure that your eyes are as symmetrical as possible after your procedure.
The surgery starts with a small incision in the crease of your upper eyelid. Then, the muscle of the lid, called the levator muscle, is tightened and reattached. This lifts the eyelid so that it no longer droops. Finally, the incision is closed with sutures that will dissolve or with sutures that are removed after 7-10 days.
Ptosis Treatment Recovery
Patients will be given ice packs, antibiotic ointment, and pain medications to apply for a few days after your procedure. Artificial tears are generally used for the first few weeks, as dryness sometimes occurs after surgery. Discomfort is usually minimal with some minor swelling, bruising, tightening, and/or numbness of the eyelids. These symptoms will last 1-3 weeks, and complete healing takes 1-3 months depending upon the patient.
After ptosis surgery, most people take 3-7 days off before returning to work. If you normally wear contact lenses, you can wear them again about two weeks after your procedure. Patients that wear rigid gas-permeable contact lenses present a special situation, and usually, a DMV plunger must be used to remove the lenses for a few months after surgery. Rarely, these lenses must be refit after surgery or cannot be worn anymore.
Additional Eyelid Surgery
If your eyelids also have excess tissue, Dr. Holds and his staff may recommend a type of blepharoplasty along with your ptosis repair to remove the excess tissue and give you the best possible cosmetic and visual result. Dr. Holds offers cosmetic, upper, lower, Asian, and functional blepharoplasty surgery. If your brows are too low as well, Dr. Holds may discuss a brow lift with you, which can be done at the same time as your ptosis repair procedure.