Ptosis of the upper eyelid: diagnosis and treatment

Птоз верхнего века: диагностика и лечение

Have you ever tried not blinking for more than a minute? Not so easy! After all, eyelids protect our eyes from any external influences, and structures such as the conjunctiva and cornea, they protect from drying out.

However, it happens that for certain reasons the eyelids, on the contrary, prevent a person from seeing and form a cosmetic defect, reducing the quality of life. This happens when ptosis of the upper eyelid.

Pathology should be diagnosed and treated in time. In this article on estet-portal.com, we will tell you everything you need to know and understand about this problem, as well as options for dealing with it.

Ptosis of the upper eyelid: what is this "dish" and what it is eaten with
Symptoms and diagnosis of drooping eyelid
Upper eyelid blepharoplasty as a surgical treatment methodia

Ptosis of the upper eyelid: what is this "dish" and what it is eaten with

Before talking about pathology, it is worth analyzing the norm. Each eyelid has its edge, each edge – anterior and posterior rib. We are talking about correct eyelid position, when the posterior rib of the upper eyelid is in full contact with the anterior surface of the eyeball.

As a result, the upper segment of the cornea is 1 mm covered by the edge of the upper eyelid, and the lower – on 1.0 – 1.5 mm does not reach the limbus (the border between the sclera and the cornea).

Blepharoptosis or ptosis of the upper eyelid – this is an abnormally low position of the eyelid, due to its omission. Distinguish:

congenital blepharoptosis;
purchased.

Congenital ptosis in turn can be:

Neurogenic - occurs against the background of underdevelopment of the eye – motor nerve;
Myogenic – occurs as a result of the complete absence of the muscle that lifts the upper eyelid, its underdevelopment or improper attachment.

Congenital ptosis is most often bilateral, acquired – one-sided.

Depending on the cause of development, several types of acquired blepharoptosis are distinguished:

Neurogenic – occurs with paralysis, trauma of the oculomotor nerve, with Horner's syndrome;
Myogenic – develops with myasthenia gravis, acquired pathology, or injury to the muscle that lifts the eyelid;
Aponeurotic – happens if the tendon of the levator muscle partially departs from the cartilaginous plate of the eyelid, age-related changes;
Mechanical – happens in the absence of the eyeball or cicatricial shortening of the eyelid.

Blepharoptosis can also be complete, incomplete and partial. Depending on this, 3 degrees of drooping of the upper eyelid are distinguished:

І degree – partial or mild ptosis (the upper third of the cornea and pupil is covered with a century); ptosis value = 2 mm.

II degree – incomplete or moderate ptosis (the cornea and pupil are half covered by the eyelid); & nbsp; pto valuefor = 3 mm.

III degree – complete or severe ptosis (the eyelid completely covers the entire pupil); ptosis value = 4 mm or more.

Symptoms and diagnosis of eyelid prolapse

Basically, the clinical picture of the disease depends on the pathology that caused it. In addition to pronounced drooping of the eyelid, people with this pathology often look tired, sleepy. To compensate for the view, a person adapts and a characteristic appearance appears:

head slightly tilted back – pose "stargazer";
appearance of deep wrinkles on the forehead due to frequent tension of the frontalis muscle to compensate for insufficient function of the levator lid muscle;
Asymmetry of the palpebral fissures.

People with ptosis of the upper eyelid most often complain of the inability to completely close or, on the contrary, open their eyes, dryness and irritation, rapid eye fatigue, functional loss of vision.

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The most important diagnostic task in this case is – identify the cause of blepharoptosis, since in the future it will determine the tactics of treatment and correction of the cosmetic defect.

To do this, during an external examination, the function of the muscle that lifts the eyelid, the circular muscle of the eye and the eye is assessed – motor nerve; examine the eyelids for the presence of neoplasms, scars and the condition of the fatty tissue of the eye fossa.

The doctor determines visual acuity and performs perimetry – test for the boundaries of the field of view and areas of their loss.

Using a slit lamp, the specialist performs biomicroscopy, while evaluating the internal structures of the eye and the fundus. The level of eye pressure is also measured.

Consultation of a general practitioner, infectious disease specialist, neurologist and surgeon

will help to identify the cause of droopingeyelids and determine the tactics for successful treatment and correction. Blepharoplasty of the upper eyelids as a method of surgical treatment

Treatment depends on the cause of the prolapse. First of all, if the cause of the disease is identified, it is eliminated and the result is evaluated. The next step is

surgical correction

drooping eyelid if still needed.

My default image

Congenital variant and permanent forms fall under surgical treatment.

The essence of the operation is to fix or tighten the muscle that lifts the upper eyelid. If she is very relaxed, the surgeon will have to lift her eyelid and eyebrow.

The choice of tactics for upper eyelid blepharoplasty is up to the surgeon, depending on the causes and severity:

the action of the frontalis muscle is transferred to the eyelid;

the action of the superior rectus muscle is transferred to the eyelid;
Strengthening the function of the levator muscle to fully elevate the eyelid, while partially maintaining its function.