Drooping Eyelid

It is the condition in which the upper eyelid limit is lower than normal and may cover part of the pupil.

In this anatomical imaging, see the upper eyelid, above the eye, and the elevator muscle, which lifts the eyelid through its innervation (tendon), which is attached to the cartilaginous support (tarsus).

What are the causes of eyelid ptosis?

The most common cause of blepharoptosis is the passage of age, which results in the stretching or detachment of the tendon and the muscle that lifts the eyelid. Also, eyelid ptosis can occur after using contact lenses. Another example is the fall in people who rub their eyes due to allergy, dry eyes, crying or frequent make-up.
Blepharoptosis can occur after trauma or previous surgery to the eye (cataract or glaucoma surgery or retinal detachment), or as an expression of another disease affecting the muscle or nerve that lifts the upper eyelid, e.g. Myasthenia gravis (myogenic fall) or palsy of the third brain nerve (neurogenic fall) as in diabetes mellitus. There may also be mechanical fall, where due to excess weight from hail, from tumor or trauma, the eyelid is fallen.
Eyelid ptosis can also occur at birth (congenital blepharoptosis), and is due to an abnormal growth of the muscle that lifts the eyelid, and can be hereditary.
Drooping eyelid can cause significant discomfort, both functional, such as limiting vision (functional), and aesthetically, since one eye looks smaller than the other or both eyes look small.

Case of a lady with a drooping upper eyelid of the left eye, which limits the field of vision.

Visual fields examined.

The functional deficit of the upper field of vision is displayed in the examination. The continuous line depicts the field of vision with the eyelid down, while the dotted line, the field of vision with the drooped eyelid raised.

What are the symptoms of blepharoptosis?

Eyelid ptosis can be from minor to severe.

Patients usually experience difficulties in vision up to total loss, as the drooping eyelid narrows the field of vision or completely covers the pupil. To cope with the eyelid ptosis and improve their visual field, patients either raise their eyebrows, resulting in fatigue in the forehead muscle, resulting in “headaches” and “fatigue in the eyes”, or raise their chin to see better, resulting in “tension headaches”, “neck pain” and “cervical syndrome”.

But there are also social or professional repercussions, as many of the patients with blepharoptosis complain that people around them say they look “sleepy”, “tired”, “sad”, “bored”, or “asleep”. Thus, in the workplace, the impression may be wrongly created that the employee is lazy or tired easily or even bored. In a job search interview, drooping eyelids (drooping eyelid) can adversely affect the eye by creating a negative impression. Also a woman or even a man with eyelid ptosis become less attractive.

In case you notice a sudden drop of the eyelid, you should be examined by a specialist ophthalmologist immediately.
The fall does not improve over time, it is likely to get worse, and almost always surgery is required to correct it.

An essential element of any surgical procedure, especially cosmetic surgery, is providing the patient with sufficient time for information.

How is the eyelid correction surgery performed?

The operation is performed through a thin incision on the eyelid, and the muscle is repositioned in its normal anatomical position. It is usually performed under local anesthesia, as a one-day surgery, without having to stay in the clinic overnight. The operation lasts about 20-30 minutes, there is no pain during or after the operation, and the patient leaves the clinic after a short time.

Will there be scars or scars on my eyelids?

The incision on the upper eyelids is made through the normal wrinkling of the upper eyelid, so that it not only hides, but also heals very nicely. The same applies to the lower eyelids. Scars can occur when the surgeon who operates the eyelids is not familiar or does not have enough experience with surgery in this delicate area. Because of Dr. Trakos focuses on ophthalmic plastic surgery, you can be sure that you will have a specialist who looks after the eyes in the most specialized way.

Does the insurance cover this operation?

Your health insurance can cover the cost of upper eyelid surgery if these cause functional problems such as significant limitation of the visual field. After the initial examination by Dr. Trako can inform you if you are eligible for insurance coverage and if further tests are needed to be eligible.
A complete ophthalmological examination with a full eyelid study will certify this potential suitability, and will require photographing and authorization from your insurance company before surgery to proceed.

Why choose Dr. Trakos?

Dr. Trakos’ contribution to the field of anterior segment and cataract surgery, as well as to the treatment of vision problems, has changed the lives of many people by improving their sight and quality of life.

How long does an eyelid correction procedure last?

A typical upper eyelid ptosis correction usually lasts 15-30 minutes

What type of anesthesia is used?

Most eyelid procedures can be performed under local anesthesia without the need for hospital stay. If desired, local anesthesia can be performed with sedation. During sedation, a relaxing drug is administered by an anesthesiologist, so that the patient falls asleep. The amount of the drug is modified as appropriate. After the patient falls asleep, an anesthetic is injected into the skin in the area where it is to be operated.

How is rehabilitation after surgery?

Depending on the patient’s previous medical history there will be a similar degree of swelling and bruising around the eyelids for about 1 week.
It is important to avoid intense physical activity during the first week after surgery, although most patients can return to work after 5 to 7 days if they wish.
Fine stitches are removed after 5 to 7 days.
There is some slight discomfort in the eye after surgery. Ice packs are recommended for the first two to three days to reduce swelling. Arnica Montana tablets, 3 days before surgery and 7 days after surgery, may help reduce edema and bruising. The bruise from the 4th-5th day can be camouflaged with a special make-up applied to the skin.

A special ophthalmic antibiotic ointment is prescribed, which is used some days after the operation.
You can’t wear contact lenses for at least 1 to 2 weeks after surgery, because the eyelids may feel heavy and uncomfortable and you can’t apply or remove the contact lens with ease, and the eyes may experience some degree of dry eye. Therefore, it is important to examine the patient who is a candidate for correction of eyelid ptosis, both before surgery and after, by the specialist in a special ophthalmological lamp-microscope. Some patients experience blurred vision or sensitivity to light for a few days, so it is so important to have an eye examination before surgery to be prepared by Mr. Trakos in case you have subclinical signs or symptoms of blepharitis or dry eye syndrome. In this case it is advisable to give you a treatment before surgery for your most appropriate preparation.

What are the benefits after eyelid correction surgery?

Increase in the field of vision
Increase of light entering the eye and improve visual acuity
Improvement of the image of the “sleepy” by correcting one or both drowsy eyelids
Improvement of “tension” headache and neck pain in patients who have been raising their eyebrows for years to see better.

My child has a drooping eyelid. Why should we definitely visit the doctor?

In order for the visual system of a child to develop normally, each eye must receive visual information separately. In the child who has a drooping eyelid, the visual axis – field of vision of the eye is covered, while in the other eye it is normal. This creates a deprivation of visual information in the brain, thus leading the eye with the drooping eyelid, to irreversibly low vision, and the child will have what we call a “lazy eye” (lazy eye).
It is therefore important to correct the eyelid surgically as early as possible to prevent permanent loss of vision.