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Ptosis: Symptoms, Causes & Treatment

Ptosis
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What is Ptosis?

Ptosis, or droopy eyelids, is when one’s upper eyelids begin to droop downward. The reason behind the drooping of the eyelid is due to various factors such as age, genetics and damage caused to the eye. A lot of times, this is due to some sort of affliction (weakening or malfunction) to the levator muscle, the one responsible for lowering and raising the eyelid (x).

Types of Ptosis

Neurogenic Ptosis

This type of ptosis occurs when the neural pathways that control the movement of eyelids get affected. Several underlying causes can cause this, including myasthenia gravis, Horner syndrome and third nerve palsy.

Aponeurotic Ptosis

This is the common type that develops due to aging. In this case, the levator muscle gets too overstretched, which makes it hard for it to return to its original form. It can also be caused by an excessive use of contact lenses and frequent rubbing of the eyes.

Myogenic Ptosis

In this type, the muscles begin to weaken, which can occur due to systemic disorders like muscular dystrophy. The weakened muscles include the levator muscle, which triggers the drooping of the eyelid.

Traumatic Ptosis

Ptosis can also be caused by an injury or trauma caused to the eye or the eyelid. When playing sports, taking care of the eyes with proper eye protection is essential.

Mechanical Ptosis

If the eyelid gets weighed down by any excessive skin or mass, then mechanical ptosis can occur (x).

Congenital Ptosis

This type of ptosis consists of a child being born with droopy eyelids. This happens because the levator muscle fails to develop properly in the womb during pregnancy. To ensure that proper vision is established, surgery is often recommended. If not treated, it can cause poor vision that is permanent and a condition called lazy eye. Children who have congenital ptosis should undergo regular examination from an eye specialist every year. As the child begins to grow, the shape and size of the eye also changes and can worsen with time (x).

Causes & Risk Factors of Ptosis

Ptosis is typically the cause of aging, but there are also many underlying health conditions and concerns that can cause it such as (x):

  • Injury
  • Trauma
  • Age
  • Tumor or infection of eyelid
  • Tumor present inside the eye socket
  • Diabetes
  • Issue with levator muscle
  • Side effect of cataract surgery
  • Side effect of corrective eye surgery
  • Muscular disorder like muscular dystrophy
  • Brain tumor
  • Myasthenia gravis
  • Stroke
  • Bell’s palsy
  • Horner’s syndrome
  • Brain aneurysm
  • Side effect of Botox injection
  • Nerve cancer
  • Eye surgery
  • Excessive eye rubbing
  • Contact lenses (x)

Eye Strain

Eye strain can be a main cause of this condition. Due to the vast amount of time spent staring at computer screens and phones for hours with abnormal light conditions, strains on the eyes are common. To avoid eye strain, make it a point to look away from the device every few minutes, blink a few times and focus on something else (x).

Symptoms of Ptosis

  • Tilting the head backwards because one is unable to see properly
  • Drooping eyelid that is very much noticeable
  • Dry eyes
  • Raising of eyebrows in an attempt to raise the eyelid for complete vision
  • Watery eyes
  • Tiredness
  • Dull pain in and around the eyes

Ptosis also looks a lot like a condition called dermatochalasis, a connective tissue disorder which causes the skin to hang in folds (x). If you notice drooping eyelids, then consult with a doctor immediately.

Ptosis Symptoms

Ptosis Treatment

Before beginning with the treatment process, a proper diagnosis is necessary to identify a potential underlying cause. This can include a detailed discussion of your medical history, physical examination, eye examination, CT scans, MRI or blood tests. The purpose of these many tests is to properly rule out underlying muscle disorders, neurological conditions and autoimmune disorders.

If the ptosis is so severe that the drooping of eyelids is causing limited vision, then surgery may be recommended. In the surgical procedure, the surgeon attempts to lift the eyelids by tightening the levator muscles to improve both the appearance of the eye and vision (x).

Like all surgical procedures, there are many risks associated with it. The eyelids may appear asymmetrical or a person may lose the ability to move the eyelids. Some other serious complications can include hematoma and scratched cornea. Thus, it is important for you to select a surgeon who is experienced with eye surgeries.

Another effective and non-surgical way of treating ptosis is the use of eyeglasses. Some special eyeglasses contain a crutch that holds up the drooping eyelids for proper vision. These crutches are attached to the inner portion of glasses in such a way that they are not noticeable. The use of these eyeglasses is quite safe and effective, but getting used to them may take a while. The only side effect is that it can cause dry eyes because the crutches will keep the eyelids open. You have to make sure to follow the directions given by your ophthalmologist to keep the eyes lubricated (x).

Natural Remedies for Ptosis

Acupuncture

If the cause of ptosis is Bell’s palsy, a neuromuscular condition or a stroke, then the use of acupuncture may help. The acupuncturist will place the needles on the scalp and facial muscles to stimulate the muscles present in the face. This treatment is long-term, and you may be required to visit the acupuncturist twice a week for a couple of months (x).

Tea Bag Eye Compress

To help with the symptoms of ptosis and ease the discomfort, soak some chamomile tea bags and cool them to room temperature. Squeeze excess tea out of the teabags and place the bags on the eyes. Be careful to place some towels behind the head to prevent clothes and bed sheets from getting stained.

Research shows that chamomile tea is good for fighting off inflammation and calming the nerves. It is touted as highly beneficial for treating eye inflammation because of the presence of various phytochemicals. When topically applied, it can help with treating various eye infections, blocked tear ducts and other eye issues.

When consumed as a tea, chamomile has been proven to have anticancer properties. It also soothes the gastrointestinal tract, helps fight off a cold and controls blood sugar in those with diabetes. For optimum benefits, take 800 mg once or twice daily (x).

Vitamin B12

Vitamin B12 is an essential nutrient for proper functioning of neuromuscular tissues. If you are a vegetarian, then you may be deficient in this vitamin. If you cannot consume meat, then try taking supplements to overcome the deficiency. To increase the intake of this vitamin in your diet, consume wild caught animals like salmon, tuna or mackerel.

Eyelid Strengthening Exercises

If ptosis is caused due to aging and decreased muscular strength, doing special exercises for the eyelids can tone down the droopiness and improve the overall appearance of the eyes. To exercise, shut both of your eyes and keep a finger on the base of the eyelid. Then try to open the eyes as much as possible. Repeat this exercise almost 15 times.

If that doesn’t work, try standing in front of the mirror. Put an index finger on the upper part of the eyelids or the lower area of the eyebrows. Raise the fingers up against the brow bone and close both eyes. Blink your eyes a few times and squeeze the eyes shut for a few seconds. Repeat this exercise almost 10 times a day (x).

Netrapana Therapy

This is Ayurvedic medicine that dates back thousands of years. It involves consuming a healthy diet (with herbal remedies) and living a generally healthy lifestyle to treat various conditions. The treatment of ptosis with Ayurvedic medicine includes pouring a combination of warm ghee, certain oils and salt over the eyes by a professional. This is a soothing treatment which can calm the nerves and muscles present in the eye area. Look for a professional with experience in netrapana therapy (x).

Eat Eye-Friendly Foods

Carotenoids and beta carotene are two components that are associated with good eye health. For people with the issue of ptosis, consuming foods rich in beta carotene can help fight off inflammation, boost the immune system, protect from various kinds of cancer and undo skin damage. When preparing a meal plan, make sure to include foods that are rich in beta carotene.

Foods rich in carotenoids can be easily identified because of their taste and fresh bright colors. Consume fruits that are bright orange, yellow and red in color. These can include tomatoes, bell peppers, papaya and winter squash.

Precautions

If your eyelids start to droop out of the blue and are accompanied by any of the following signs, then seek medical help in emergency form:

  • Double vision
  • Eye infection
  • Fever
  • Bulging eye
  • Migraine headache
  • Pain in the eye area
  • Muscle weakness, even in arms and legs

The Bottom Line

Ptosis reflects a condition associated with the eyes and is typically caused by aging; however, if you notice drooping eyelids out of the blue and it happens to develop quickly, then it may be a sign of a serious health condition. This can include migraine, diabetes, stroke, brain tumor, cancer, aneurysm or another medical issue.

Drooping eyelids can occur in only one eye or both; and sometimes it is so serious that it can affect vision to a great extent. In serious cases, surgery is necessary to treat this condition. Some children are also born with ptosis at birth, and not getting it treated can exacerbate vision issues for an entire lifetime. Treatment for ptosis includes both surgical and nonsurgical options like a healthy diet and eye strengthening exercises.

About the author

Mahnum Shakoor


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