What is a Ptosis?

Ptosis (toh-SIS) is short for blepharoptosis. Ptosis is known as the dropping or falling of the upper eyelid over the eye. This happens when the border of the upper eyelids fall into a lower position than normal. In mild cases the upper eyelid might just droop a little, which is barely noticeable. However, in more severe cases it can cover the pupil which blocks the light from entering the eye and this can affect vision. Ptosis can present in one eye or both eyes. It can happen in both children and adults. The great news is this eye condition can be treated to improve vision as well as appearance cosmetically which helps improve the quality of life.

The three main reasons for droopy eyelids are dropping of the eyebrow, excessive skin of the upper eyelid and the dropping of the actual upper eyelid by itself. Ptosis can be congenital or acquired. Congenital ptosis normally presents at birth and occurs when the muscle that lifts the eyelid known as levator muscle does not develop well. Common signs of ptosis seen in children is a drooping eyelid or the upper eyelid creases are not aligned evenly with each other. Usually a child with ptosis will try to move their head back, lift up their chin, or raise their eyebrows in order to see well. Gradually, these will cause a child to have head and neck problems. In more severe cases, droopy lids that cover the pupil will affect the vision as well. In the long term, it can cause amblyopia or lazy eye. Some children with ptosis can develop astigmatism, strabismus or crossed eyes.

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Acquired ptosis usually happens in later life in adults due to aging where the levator muscle stretches or separates away from the eyelid. This can happen by an eye injury (trauma) as well. Sometimes, acquired ptosis can also present after an eye surgery such cataract, botox injection, contact lens wear, tumours, in neurological disorder or systemic disease. Therefore, droopy eyelids can be a warning sign of severe medical problems.

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A series of eye examinations will be done by an ophthalmologist to rule out the cause of droopy eyelids for better treatment outcome. Common eye examinations include vision test and refraction especially in children to improve their vision. In moderate and severe droopy eyelids cases, surgical treatment is required for proper vision development to avoid amblyopia (lazy eyes) and poor vision. Surgical treatment for patients with normal levator muscle function is done by tightening the levator muscles that lift up eyelids and hence improve vision and appearance. In advanced cases, for patients with poor levator muscle function, the surgery is done by attaching the eyelid under the eyebrow with a sling which will help to lift the upper lid and improve vision.

Residents within Klang Valley in areas such as Cheras, Puchong, Shah Alam, Petaling Jaya, and Kepong can come visit our oculoplastic surgeon, Dr Tai Lai Yong to have their eyes examined.

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Double Eyelid Surgery

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Double eyelids are visible eyelid creases. Some people were born without eyelid creases, that’s called single lid or monolid.

Most Asians are born with single eyelids, which is commonly due to absence of fibrous ligament connecting the tarsal to the eyelid skin. Double eyelids are the beauty standard of today and most people want double eyelids to have an appearance of larger eyes and easier to create a platform to apply make-up. So if a person wants to have double eyelids, then can undergo a surgery that aims to create double eyelids. This procedure can be done under outpatient basis and under local anaesthesia, which means the person can go home on the same day after the procedure.

There are two main methods of double eyelid surgery, which are non-incisional and incisional methods. Non-incisional method is the most common method that doesn’t require removal of skin or fat. The surgeon will create a double eyelid crease by insertion of suture. The healing time for non-incisional method is faster, within 2 weeks. Furthermore, this method causes less scarring and it can be reversible. While using the incisional method, the incision will be made along the eyelid and skin or fat will be removed. People with excess skin and fat on the eyelid are suitable for the incisional method. However, this method may have a longer recovery time up to 4 weeks. There are also non-surgical techniques for creating a double eyelid appearance which is eyelid tape or glue that can be found in drugstores or beauty stores.

There are two main methods of double eyelid surgery, which are non-incisional and incisional methods. Non-incisional method is the most common method that doesn’t require removal of skin or fat. The surgeon will create a double eyelid crease by insertion of suture. The healing time for non-incisional method is faster, within 2 weeks. Furthermore, this method causes less scarring and it can be reversible. While using the incisional method, the incision will be made along the eyelid and skin or fat will be removed. People with excess skin and fat on the eyelid are suitable for the incisional method. However, this method may have a longer recovery time up to 4 weeks.

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There are also non-surgical techniques for creating a double eyelid appearance which is eyelid tape or glue that can be found in drugstores or beauty stores. After the surgery, there will be some discomfort and swelling of the eyelid. Medication will be prescribed after the surgery to reduce inflammation and reduce the risk of infection. For a smoother recovery, eye rubbing, eye cosmetics, strenuous or vigorous exercise should be avoided for about two weeks at least. Most individuals would be able to see a relatively natural look of the double eyelid in about three weeks after the surgery. Proper compliance of patients to the medication regime and post-operative care during recovery period will result in a better surgery outcome.

Consult with an eye doctor to find out if you are a good candidate to do the surgery. There are pros and cons of doing double eyelid surgery. During consultation you should discuss in detail about the preferred method of surgery, type of anaesthesia, expectation of the surgery, potential risk of surgery and post-operative care and recovery. After the surgery, there will be some discomfort and swelling of the eyelid. Medication will be prescribed after the surgery to reduce inflammation and reduce the risk of infection. For a smoother recovery, eye rubbing, eye cosmetics, strenuous or vigorous exercise should be avoided for about two weeks at least. Most individuals would be able to see a relatively natural look of the double eyelid in about three weeks after the surgery. Proper compliance of patients to the medication regime and post-operative care during recovery period will result in a better surgery outcome.

Consult with an eye doctor, preferably an oculoplastic surgeon to find out if you are a good candidate to do the surgery. There are pros and cons of doing double eyelid surgery. During consultation you should discuss in detail about the preferred method of surgery, type of anaesthesia, expectation of the surgery, potential risk of surgery and post-operative care and recovery.