Full Eyelid Ptosis Correction in a 2-year-old Possible Through Surgery?

My son has a droopy left eye since birth. He is able to open only half of his eyes. If an eyelid surgery is required, will this ptosis be corrected 100%? He is 2 months old now.

Doctor Answers 7

Congenital ptosis

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I would recommend having a pediatric ophthalmologist evaluate your child and make sure the visual axis is not being blocked by the eyelid or the weight of the lid is not causing astigmatism, these things could cause amblyopia (lazy eye) which could permanantly damage the vision. The surgery can be a little unpredictable due to the fact that the other eye is closed and the baby is under general anesthesia, so symmetry could be of issue. Each of these cases need to be treated like cosmetic cases with concern for the contour and height and symmetry of the eyelids. The type of ptosis repair should be determined by the oculoplastic surgeon that evaluates your child.

Treatment for congenital ptosis

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Hi Nithya - It sounds like your child has congenital ptosis, and this can be corrected by attaching the forehead muscles to the eyelid so that it opens. General anesthesia is required, but it is usually a very successful procedure. Call around for a pediatric plastic surgeon for a full assessment. Good luck!

Need immediate assessment by a pediatric ophthalmologist

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Hi Nithya

The heavy eyelid in a 2 year old is called congential ptosis. The concern here is that the heavy eyelid can actually cause a lazy eye by blocking the normal development of the eye with the heavy upper eyelid. Initial approach entails an office consultation with a pediatric ophthalmologist who will examine your son to determine if he is using the eye with the heavy upper eyelid.

It is not unusual in these situations for the child to neglect the eye that is covered. The problem here is that means that the vision will not develop normally. If this is the case, initial treatment involves patching the good eye to force use of the partially covered eye. Once the vision improves with this treatment, the next step is eyelid surgery to prevent the lid from interfereing with visual function. No surgery is 100%. Part of the issue in these kids with heavy upper eyelids is that the muscle that lifts the eyelid is often not completely formed. It is not unusual for someone born with congenital ptosis to require many eyelid surgeries during their lifetime.

I recommend you call your son's pediatrician and get a referral to a pediatric ophthalmologist. In Phoenix, you will have the choice of several pediatric ophthalmologists. Start with the one who accepts your son's health insurance. Given his age, this assessment should be done within 10 days.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Congenital ptosis needs evaluation now

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Please take your child to an Ocular Plastic Surgeon or Pediatric Ophthalmologist now. If your child's vision is being blocked by their eyelid, they can develop amblyopia. Amblyopia is the poor development of sight which is possible to improve at a younger age but if left untreated can be permanent. Through www.ASOPRS.org you can find a qualified ocular plastic Surgeon for your child's evaluation.

Pediatric ptosis has many corrective methods to lift the eyelid but it is never possible to give a 100% guarantee. Some children need more than one procedure to help achieve appropriate height and contour. Some children can have the muscle called the levator lifted (or tightened); while others may have a "sling" that allows the eye brow muscles to be used to lift the eyelid.

Conegnital Ptosis a Difficult Problem

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Dr. Rand is absolutely correct.  Congenital ptosis is a tricky problem.  I would encourage you to speak with an ASOPRS trained Occuloplastic surgeon, realizing that there are no guarantees.

Correction of eyelid ptosis in a 2 year-old

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I am sorry to hear your son has this problem.  This is not the forum to ask this because what you need is an expert pediatric ophthalmologist to be orchestrating the care.  I doubt you will get a 100% guarantee from anybody however. 

Congenital ptosis is different from adult ptosis and harder to correct

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Congenital ptosis is a condition in which the levator muscle which raises the lid fails to develop normally. Surgical repairs are designed to prevent a lazy eye (amblyopia) and to maximize eyelid symmetry. If amblyoipa is the issue, early repair is essential. The other important issues of peer interaction, facial symmetry are best addressed at a slightly older age -about the time the child starts school.

Your oculoplastic surgeon or pediatric ophthalmologist will be able to help with the timing and the repair.

While 100% improvement is not possible, very good results can be obtained for your child.

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.