
Eye Health
Ipoh Echo’s Eye Health series continues with Consultant Eye Surgeon Dr S.S. Gill talking to us about Drooping Eyelids or Ptosis.
Ever seen your older friends slowly begin to have droopy or sagging eyelids? Well this condition is fairly common in old age. It is called dermatochalasis and the eyelids appear to sag with excess “baggy” skin surrounding them. This is the age related cause of a droopy eyelid.
It is sometimes referred to as Ptosis (pronounced “toe-sis”) which is the general term for a droopy eyelid. There are many general causes for a droopy eyelid to occur. They are:
Congenital — The child is born with drooping eyelids because of a problem in development of the eyelids. Most of these cases affect only one eye. It is important to look out for the drooping eyelid that blocks off the vision of the eye in a child. If this occurs, then surgical correction has to be done early to prevent the development of a “lazy eye” or “amblyopia”.
Local eye problems — In some cases, the eyelid starts drooping because of nerve injury due to trauma, eyelid infections and tumours within the bony cavity or eyeball socket.
Age related ptosis (Aponuerotic Ptosis) — This also may be referred to as dermatochalasis. Due to the long-term effects of gravity and the aging, it causes the eyelid skin to sag over the eye. Both eyes are usually affected but drooping may be worse in one eye.
Myasthenia gravis — This is a disease that can affect the whole body causing progressive muscle weakness. The eyelids as well as facial muscles including the legs, arms and other parts of the body may be affected. This condition will require a thorough assessment and treatment by a physician or neurologist. A test called Tensilon test where a drug called edrophonium chloride is injected into a vein in order to diagnose this condition.
Nerve problems — Any nerve damage due to a stroke, aneurysm of blood vessel in the brain and brain tumour may cause a droopy eyelid. Nerve damage due to longstanding diabetes mellitus may also cause a droopy eyelid.
Tumours — There is also a condition called Horner’s Syndrome where a cancerous tumour at the top part of the lungs results in one half of the face losing the ability to sweat along with a drooping eyelid.
Strokes — Any nerve damage due to a stroke, aneurysm of blood vessel in the brain and brain tumour may cause a droopy eyelid. Nerve damage due to long-term diabetes can also cause a droopy eyelid.
When the drooping eyelids cover a person’s vision causing a vision disturbance, the person usually ends up COMPENSATING UNCONSCIOUSLY BY USING THE MUSCLES OF THE EYEBROWS TO LIFT THE AFFECTED EYELIDS UP (see pic on the left). The person may also end up unconsciously tilting the chin up or tilting the head back as a method of seeing through the lower part of the eye. All this may cause the person to have headaches and even neck problems in the long run. Whatever the cause of a drooping eyelid may be, if you are unsure of the cause, get it checked out by a doctor.
For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-5455582) or email gilleyecentre@dr.com.