Hi doctors. I suspect I have a ptosis because I find my eyelids constantly straining to stay open (similar to constant stretching of a muscle) and when I raise my eyebrows the eyelid crease don't move up with it, so this doesn't help much. Is this a "levator dehescience" type of ptosis, and which specialists are good for correcting this functional problem?
Best Specialist for Ptosis Repair?
Doctor Answers (6)
Ptosis repair can resolve your symptoms
Your description sounds like a classic ptosis. However there are number of factors you need to consider first. such as : (1) Your age. (If you are young, you need to consider causes other than levator dehiscence), (2) laterality (Is this on one side or both sides?), (3) Onset (How quickly did this come about?), (4) variability (is the ptosis constant throughout the day)
The good news is that a lot can be done once you've undergone a careful workup. Oculoplastic surgeons are particularly well trained to evaluate and treat this condition. Good luck
You will full evaluation, pictures will help
You need to find a board certified plastic surgeon to evaluate you. Plastic surgeon will evaluate not only your eye,but also your eye brow position and movement,facial dimension and symmetry. You may need more than ptosis repair to improve the function and also shape of your eyes and qualified plastic surgeon can help you.
You need an oculoplastic specialist
Besides ptosis, there are other conditions that would cause you to have trouble keeping your eyes open, such as conditions called blepharospasm or even neurological conditions such as myasthenia gravis that often presents with difficulty keeping the eyes open. I would say that the most common cause of the symptoms you describe would be ptosis, and there are multiple ways to improve the condition, depending on your examination. I would certainly recommend an oculoplastic surgeon who is an ophthalmologist specialized in eyelid and orbital diseases. This kind of surgeon can best sort out the symptoms and diagnose your problems most accurately. The ASOPRS web site is an excellent resource to help you find a member in your area.
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Brow and eyelid ptosis
I don't see any signs of levator problems. You have ptotic brows and ptotic skin of the upper lids. The correction would include endoscopic brow lift with a standard upper blepharoplasty. Manually lifting the brows is an inadequate test because that's only half of the problem.
You would benefit from seeing an oculoplastic surgeon.
To assess your issue, you need to see an oculoplastic surgeon. This is someone who is a board certified ophthalmologist and has specialized fellowship training in oculoplastic surgery. The highest standard is ASOPRS fellowship which means that the individual completed an accredited fellowship or devotes a significant percentage of their practice exclusively to oculoplastic surgery. Based an examination of your eyelids, this surgeon will be able to tell you what precisely is going on and how best it should be addressed.
Eyelid ptosis can be diagnosed by Plastic or Oculoplastic surgeon
If you have a lot of "excess" upper lidI, the crease may not move when the eyebrows are elevated, as the levator is attached to the lid only at and below the eyelid crease, and the dehiscence, or disconnection is often above this level,(going "back" towards the eyeball) . If you consult with a Plastic Surgeon and are found to have a levator dehiscence, a referral to their trusted Oculoplastic Surgeon will usually occur as this is a specialized "fine-tuning" type of surgery.