CPtosis

Ptosis (pronounced as toe-sis, the P is silent) means drooping of the eyelid. It can be unilateral (in one eye) or bilateral (in both eyes).

Cause -

Weakness of the levator muscle, which lifts the upper lid.

Other problems may be associated with ptosis like-

	Less corneal sensations
	Narrow lid fissures - blepharophimosis
	Outward turning of the lid - ectropion
	Extra lid fold on inner side of eye - epicanthus.
	Abnormal nerve supply- ptosis changes on opening mouth called Marcus-Gunn ptosis.

Management

If the droopy eyelid is present since birth and is severe, it requires surgery. If that eye remains covered, the vision in it will never get a chance to develop. This will cause "a lazy eye". Early surgery may prevent a lazy eye in children.

Various surgical options exist depending on the presentation.

	If levator muscle is the culprit, then its length is decreased, the lax muscle is excised, called resection, so that the lid is lifted up.
	When bilateral, the fascia from the thigh may be used to lift up both lids.
	Non-absorbable sutures are used to hold the lid in position.