What is it about ?
When one or both upper eyelids fall (s) and hide (s) part of the white of the eye, it is called blepharoptosis. It indicates that the muscles that lift the upper eyelid are not functioning properly. Blepharoptosis can be primary (congenital) or secondary (following an illness).
Primary blepharoptosis usually affects only one eye. No one knows for sure whether it results from a malfunction of the eye muscles or the nerves that control the eye muscles. Secondary blepharoptosis is caused by a disease of the muscles (for example, myasthenia gravis) or a nerve disorder associated with paralysis of the muscles of the eyes.
In older people, blepharoptosis is usually caused by weakening of the tendons of the levator muscle of the upper eyelid, possibly favored by prolonged wearing of contact lenses. A mechanical cause (swelling of the sebaceous glands, for example) can also lead to blepharoptosis.
Some people have too much skin on the eyelid, which can cause it to sag. In this case, it is not a disease and it should not be confused with blepharoptosis.
How to recognize it?
The eyelid is slightly drooping. Because of this, one eye looks smaller than the other. When the person looks up, their eyelid does not follow the movement and the eye disappears under the eyelid.
In severe blepharoptosis, the eyelid covers the pupil and sight does not develop normally. In children, this can result in a “lazy eye”, associated with reduced and blurred vision.
What can your doctor do?
When a newborn has blepharoptosis, treatment is if possible postponed until school age (4-5 years). If the pupil is clear and sight can develop normally, there is no rush. Sometimes the healthy eye is covered with a mask to stimulate the “lazy” eye. If the eyelid covers the pupil, surgical correction is necessary from early childhood to ensure normal development of sight.
Sudden blepharoptosis in adults will be investigated immediately, first by a neurologist. Depending on the results, treatment may be started.
Mild blepharoptosis, without consequences for vision, does not require treatment. On the other hand, if vision is impaired or if the blepharoptosis is aesthetically embarrassing, the eyelid may be lifted by means of an operation.
If there are no symptoms, it is not necessary to treat excess skin on the eyelid. The excess skin can possibly be removed during cosmetic surgery.
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