I was born with my left upper eyelid drooping lower than my right, thus, it makes a lazy left eye effect. I think (after reading numerous articles online) that my levator muscle is weak or inactive. I am seriously considering having it corrected. Is Blepharoplasty the procedure I should be researching on? Will this involve intensive recuperation afterwards?
Blepharoplasty for Lazy Eye?
Doctor Answers 10
Blepharoplasty for a Lazy Eye
It sounds like you need ptosis repair for correction of the lazy eye. At the same time, your surgeon may perform an Upper Lid Blepharoplasty to make the eyelids symmetry.
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Greater benefit with ptosis repair
A blepharoplasty is not performed for a lazy eye. Ptosis repair is performed for a lazy eye. Even though only one eye may be lazy, usually both eyes are performed because of the reflex between both eyelids and the brain. Blepharoplasty is only done for cosmetic purposes, not functional opening of the eyelid.
The procedure you need is probably ptosis repair
If indeed your levator muscle is weaker and your eyelid covers the colored portion of youe eye or even the pupil on the affected side, it could be interfering with your vision, so your problem could be functional as well as cosmetic. Many plastic surgeons are experienced in these repairs, as well as some opthalmologists. Be patient with the procedure, as it can be difficult to get "perfect" symmetry with the unaffected side, if you only chose to operate on the side with the ptosis. Insurance might cover this because of the visual field obstruction.
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See an Oculoplastic Surgeon
MJ in NJ,
It sounds like you have congenital ptosis, as you mentioned this is usually a disability of the levator aponeurosis. A lazy eye is amblyopia which is more of a poor vision issue in that eye secondary to the brain not recieving the proper impulses during childhood to allow the visual axis to grow. Ptosis could be corrected by doing surgery on the levator muscle if it is strong enough. If it is not then the levator might need to be attached to the forehead muscle. You could still need a blepharoplasty to excise excess sagging skin, but that should not be confused with ptosis, a drooping of the eyelid from weakness or damage to the levator muscle. The eye actually "looks smaller" in this case. Find an Oculoplastic surgeon to address this issue.
There may be some confusion: diagnosis and treatment
Mj171 in nj:
There may be some confusion about both diagnosis and treatment. Having one eyelid sag since birth may represent ptosis, not "lazy eye." Treatment would be ptosis repair, not blepharoplasty. However, you need in-person assessment and recommendations from an experienced surgeon.
Some plastic surgeons are very experienced in ptosis repair, but many do not perform this procedure. Inquire when you make an appointment or request a referral. Ophthalmologists with additional eyelid surgery training (oculo-plastic surgeons) would be a good source for care. Ask you local physician's office to refer you or seek one of these specialists through national websites for their professional organizations.
Blepharoplasty with Ptosis repair may be appropriate
Your condition should be evaluated by ophthalmologist prior to referral to a surgeon accomplished in blepharoplasty with ptosis repair if in fact your diagnosis involves dysfunction of the levator muscle.
Eyelid ptosis need to be assessed by an Oculoplastic surgeon
Dear MJ in NJ
Eyelid ptosis is a relatively common situation. It is not a lazy eye. Lazy eye is a lay term for an eye that does not align properly. Generally when this occurs, it is the results of an early developmental issue with lack of a properly formed image on the back of the eye, or some other circumstance leading to an abnormal neural wiring. The medical term for this condition is amblyopia and diagnosed early this can generally be treated with patching and if necessary surgery.
Upper eyelid ptosis in infants can lead to occlusion amblyopia and require early surgical intervention. However, with early diagnosis and treatment, normal visual development can occur. However, it is remarkable how much eyelid heaviness can be tolerated without interfering with visual development.
Blepharoplasty in a general term for eyelid surgery. You sound like to need a specific type of eyelid surgery called ptosis surgery. General plastic and facial plastic surgeons are not trained to assess or perform eyelid ptosis surgery. General ophthalmologist receive some training to assess and perform these procedures. However, the specialist you need to see is an oculoplastic surgeon. These are board certified ophthalmologists who have done an approved fellowship in eye plastic surgery. These are two year fellowships that offer a vast experience in eyelid plastic surgery. The American Society for Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) currently supervises these fellowships although they are in the process of being accredited through the Council for Graduate Medical Education. The ASOPRS maintains a website with a member directory to assist you in finding an ASOPRS member in your area (ASOPRS.org).
Blepharoptosis is best evaluated by an Ocular Plastic Surgeon
Ptosis a drooping of the eyelid is best evaluated by an ocular plastic surgeon. Congenital blepharoptosis can be surgically treated by tightening of the levator muscle aponeurosis. Ocasionally the forehead muscles are used to lift the eyelid. Recuperation from both procedures is a matter of days. There are excellent ocular plastic surgeons in New Jersey.
True drooping eyelid requires levator surgery, not blepharoplasty
From your description, it sounds like you have what is called ptosis, which is dysfunction of the levator palpebrae superioris muscle.
You do need a formal ophthamologic exam for diagnosis. Your eye doctor will refer you to a plastic surgeon who does the levator surgery.
A blepharoplasty can also be combined with the levator surgery to achieve symetry between the two eyes.
Expect 10 days to 2 weeks recovery time although the levator repair may need 4-6 weeks for final eyelid position and results.
You need to see a doctor not your computer
See a doctor - self diagnosis will not help you. First, be evaluated by an Ophthalmologist. If you have true Ptosis , surgery can help, but not a purely cosmetic Blepharoplasty. Not all plastic surgeons take care of true ptosis, so get advice from a qualified physician, not the Internet.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.