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Eyelid Surgery
(Ptosis of upper eyelid)
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The word PTOSIS is synonymous of fallen. Ptosis of the upper
eyelid means that the level of the upper eyelid is under the
normal parameters, and it interferes with the field of view.
It is classified depending on the moment of life in which it
appears, the conditions and what causes it.
Basically there are two classes of Ptosis of the upper
eyelid:
1.-Congenital Ptosis: It occurs when the patient is
born with this pathology.
2.-Acquired Ptosis: It is when the Ptosis appears for
the first time in any stage of life that is not birth.
3.- Congenital Ptosis can affect one or both upper
eyelids, and it is caused by a dystrophy of the eyelid’s
elevating muscle.
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Before |
After |
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The Acquired Ptosis can affect one or both eyelids depending on
the cause.
Among these
causes we can find:
a.
Neurogenic:
When there is an alteration of the Common Ocular Motor nerve,
which is the one that commands the elevating muscle.
b.
Miogenic:
An alteration of the Elevator Muscle’s body occurs, as in the
Myasthenia Gravis
c.
Aponeurotic:
It’s when the Aponeurosis of the Elevating Muscle detaches partially or
totally , or it stretches, or it debilitates. This happens frequently and
mainly to adult patients, on one or both eyelids. It is related to aging
or traumas. Some say that the use of bifocal lens and contact
lenses could be another probable cause of Aponeurotic Ptosis
d.
Mechanical:
A tumor in the upper eyelid or an excess of eyelid skin can force the level
of the eyelid to be under the normal position. In this case the extirpation
of the tumor or an aesthetic blepharoplasty would help this condition
disappear. The treatment will depend on the cause.
Picture 1.-. -
This is a patient with an Acquired Ptosis of the upper eyelid, which has an
Aponeurotic origin. The patient came to my office to have it corrected. You
can observe the low level of the eyelid when looking forward.
Picture 2.-
The ptosis can still be observed when patient is looking upwards.
Picture 3.-
The ptosis is corrected performing a surgical plicature of the Elevator’s
Aponeurosis. Looking forward
Picture 4.-
The results of the surgery, patient is looking upwards.
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