Some children are born with a condition called congenital ptosis – in which the upper eyelid on one or both sides hangs down lower than is normal and can interfere with your child’s vision. If you have noticed that your child has a droopy eyelid on one side, which can present at birth or within the first few years of life, then your child may have congenital ptosis.
Congenital ptosis is not a rare condition. Many people have an asymmetry in the height of their eyelids, and it may be a very mild case not requiring surgery. A more severe case may require surgical treatment. If you notice that you are not able to see your child’s pupil – the dark circle in the middle of the colored part of your child’s eye – because it is covered by the eyelid, or if the eyelid is encroaching on the pupil, contact your pediatrician or Dr. Eftekhari’s office for an evaluation. Dr. Eftekhari has extensive experience treating congenital ptosis. During his training, he worked with one of the foremost experts on pediatric eyelid disease, Dr. James Katowitz, who published the main textbook on this topic, Pediatric Oculoplastic Surgery. In addition, Dr. Eftekhari practiced as a faculty member at the University of North Carolina at Chapel Hill, where a significant portion of his practice was dedicated to caring for children.
Evaluation of Congenital Ptosis
During your consultation, Dr. Eftekhari will measure the height of your child’s eyelid and the strength of the muscle that lifts the eyelid. Depending on these two factors, Dr. Eftekhari may recommend surgery. If you have pictures of your child when the eyelid is drooping, it would help Dr. Eftekhari to bring those to your consultation.
Treatment of Congenital Ptosis
Unfortunately, there is no medical treatment for congenital ptosis. Surgery is the only treatment option, but Dr. Eftekhari is very conservative and will only recommend surgery for your child when he believes it is necessary for developing normal vision. The surgery can range from a small eyelid procedure performed on the underside of the eyelid with no visible scar to a more extensive procedure called a frontalis sling where Dr. Eftekhari will connect the eyelid to the forehead muscles to help your child’s eye open more. This is required when the strength of the eyelid muscle is so poor that it will not lift the eyelid more than 4 millimeters. Surgery is performed on an outpatient basis and is under 45 minutes per eye.
Frequently Asked Questions about Pediatric Ptosis / Droopy Eyelid
Congenital ptosis, or droopy eyelid, in children is often caused by a weakness in the muscle that lifts the eyelid, known as the levator muscle. This weakness can be present at birth or develop shortly after.
Congenital ptosis is not uncommon and can affect children of all ages, including newborns. It may occur in one or both eyes and can vary in severity.
Symptoms of congenital ptosis may include a droopy eyelid that obstructs vision, asymmetry in the height of the eyelids, and difficulty fully opening the affected eye.
Congenital ptosis is typically diagnosed through a physical examination by an ophthalmologist or oculoplastic surgeon. The height of the eyelid and the strength of the lifting muscle are assessed during the evaluation.
In most cases, surgery is the primary treatment option for congenital ptosis in children. However, milder cases may be managed with conservative measures such as patching the stronger eye to encourage visual development.
Ptosis surgery for children aims to elevate the droopy eyelid to improve vision and symmetry. The procedure may involve tightening or repositioning the eyelid muscle, depending on the severity of the ptosis.
Yes, ptosis surgery in children is typically performed under general anesthesia to ensure the child's comfort and safety during the procedure.
Recovery from ptosis surgery in children is usually quick, with minimal discomfort. Eye drops or ointments may be prescribed to aid in healing, and follow-up appointments will be scheduled to monitor progress.
As with any surgical procedure, there are risks associated with ptosis surgery in children, including infection, bleeding, and temporary or permanent changes in eyelid position. However, these risks are rare when the surgery is performed by a skilled ophthalmic surgeon.
While congenital ptosis may be present at birth, surgery is typically postponed until the child is a few months old to allow for proper assessment of eyelid development and muscle strength.
The need for additional surgeries for ptosis in children depends on various factors, including the severity of the ptosis and the child's growth and development. Your child's surgeon will discuss the long-term outlook and potential need for future interventions during the initial consultation.
Contact Us
For personalized consultation and evaluation of your child’s congenital ptosis with Dr. Kian Eftekhari at Eyelid Center of Utah, please schedule an appointment today. Our compassionate team is dedicated to providing the best care for your child’s eye health and vision.