Palpebral ptosis is a drooping or falling of the upper eyelid and it is due to a dysfunction of the muscle that is responsible for its movement which is called upper eyelid levator. It may be congenital or acquired. Unilateral or bilateral. Congenital ptosis is usually caused either due to a congenital hypoplasia of the eyelid levator muscle (poorly developed muscle) or because of its paralysis.
Acquired ptosis can be due to several causes. The most common of them all is the disinsertion of the levator aponeurosis which usually affects old people as a result of the palpebral structures aging. It may as well be associated to muscular diseases such as myasthenia gravis (myogenic ptosis) or third cranial nerve paralysis (neurologic ptosis) accompanied by strabismus in this very case.
Palpebral ptosis originates an aesthetic defect. The more drooped is the eyelid, the more important is the fault. However, it may also cause a functional flaw depending on whether the eyelid covers the pupil or not. Therefore, in cases of complete congenital ptosis, surgery becomes an “emergency” for if the problem isn’t solved soon enough it will lead to an amblyopy of serious consequences due to a lack of use.
Ptosis treatment is always a surgical one and the applied technique will depend on the dysfunction degree of the levator muscle. If it doesn’t work at all the most suitable technique will be the frontalis suspension. If the muscle works, a resection can be done, and when the cause is a disinsertion of the aponeurosis, then this one must be replaced.