Ptosis & Dermatochalasis
Ptosis is a drooping or falling of the upper eyelid. If severe enough and left untreated, the drooping eyelid can cause other conditions, such as amblyopia or astigmatism. This is why it is especially important for this disorder to be treated in children at a young age, before it can interfere with vision development. It can affect one or both of the eyes.
Ptosis can have many causes:
Dysfunction of the muscle that raises the lid. This can be present from birth (congenital) or acquired through trauma, inflammation, eye related surgery, or underlying conditions (eg. myasthenia gravis, diabetes, and Horner's syndrome).
Excess skin and fat, pushing the lids down (dermatochalasis)
Covered by Alberta Health
Not covered by Alberta Health
Iopidine - For mild cases of ptosis, we will sometimes offer a trial run of Iopidine eye drops. These drops are a prescription drug generally used for patients with increased intraocular pressures, however they have a short term side-effect of lifting the eyelid(s) up about 1-3mm.
This option is especially good for patients who would rather not undergo surgery and just want a slight lift for special occasions, for example. This Cinderella effect will wear off in about 8 hours.
It is, however, not recommended for long-term use.
Treat the underlying condition - For the acquired cases from diseases or inflammation for example, if the contributing cause is treated then the ptosis may resolve.
Botox - Some forms of ptosis can be corrected by having Botox injected into the brow and forehead to lift the brow. This treatment is not covered by Alberta Health and needs to be repeated every 3-4 months.
Surgery - There are many surgical options available depending on the type of ptosis you have.
For ptosis caused by muscular dysfunction, the surgeon can tighten the muscle that holds the lid up, or place a suspension sling to help the weakened muscle.
For ptosis that is secondary to excess skin and/or fat, or even a drooping brow, the surgeon will need to correct the contributing problem. A brow lift can be performed to elevate the brow, or a blepharoplasty can be done to remove the skin and/or fat.
Unfortunately the surgeries are not always covered by Alberta Health. Current guidelines are that the upper lids need to be drooping and obscuring 50% of the visual axis to be covered.