What are the symptoms of ptosis? Is ptosis more common for those of Asian descent? Is Asian eyelid surgery the only option?
Is Asian Eyelid Surgery an Option for Ptosis?
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Ptosis in the Asian eyelid
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Eyelid position does vary among different ethnic groups, and is lower in Asians
In a study published in the Archives of Facial Plastic Surgery [see link below], we were able to demonstrate that eyelid position DOES in fact vary among different ethnic groups. The study did not address the incidence or rate of development of Ptosis among difference ethnics groups, however.
Margin-to-Reflex Distance [MRD] refers to the distance from the center of the pupil to where the eyelid rests in the natural open position. On average, a distance of 2 mm or less is considered low enough that it can cause visual field compromise.
However, in someone who normally has an MRD of 5 mm [average for caucasians], if it diminishes to 3 mm, it is still considered ptosis, though not bad enough to cause a visual field compromise.
In our study we were able to show that the average MRD distance in Asians is about 3.8 mm, as opposed to 5.1 in Caucasians. This means that asians on average, have a smaller "cushion of safety" before ptosis will cause visual field compromise. It is important to understand this anatomic difference among different ethnic groups in the decision making process of ptosis repair.
Here is the article citing. You can google for full article.
Arch Facial Plast Surg. 2009;11(5):303-305
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Asian eyelid surgery and ptosis
Most people regardless of race have slight asymmetry in the level of the upper eyelid position. When performing double eyelid surgery, the asymmetry needs to be addressed more precisely than in a standard eyelid procedure. Mild ptosis is common and is usually seen as looking "sleepy". Most people will undergo double eyelid surgery at the time of ptosis repair, but certainly can be separated out. If the ptosis is severe, it probably should be performed separately from the double eyelid surgery.
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