If I had Congenital eyelid ptosis, wouldn't my Optometrist have diagnosed by now?

Question

I posted a picture of my eyes on here and doctor said I may have congenital eyelid ptosis. If I did have that wouldn't it have been found bc I wear glasses so I have been to a Optometrist for eye check ups for my sight. Also my eyelids have been they way they are since I was born.Is it considered a normal thing to be born with? Is it common for babies to be born with it if it doesn't effect there vision?Is the cost for this surgery covered by health insurance? What if u have congenital eyelid ptosis but it doesn't affect your vision would it be covered?

John J. Martin, Jr., MD · Answer

if you have had this appearance since birth then you have a congenital ptosis.  For children who have ptosis, it is important to have the lid height evaluated at a young age.  If the lid is covering the pupil, the sight will not develop normally, and they will need surgery.  If you lids are above the pupil and you do not have any visual issues then it can be done at a later age.  An optometrist may notice that the lids are low, but they are not medical doctors or surgeons and if it is not bothering you, they may not refer you to an appropriate specialist.  You should see an oculoplastic surgeon who can check your lid height and evaluate the muscle function to decide what surgery might be best if you wish to do that.

Kenneth D. Steinsapir, MD · Answer

However the are not eye M.D.s.  They never went to medical school.  In their training, they primarily work with healthy eyes needing refraction or glasses, contact lens fitting.  They are exposed to limited information on oculoplastic surgery.  Unfortunately in some healthcare systems, they may be the only eye care person you see unless you actually have a medical issue.  It is not realistic to hold them to the same standard as an ophthalmologist.  Ask for your primary care physician for a referral to an oculoplastic consultant.

Garrett Griffin, MD · Answer

Hi Sandra 782: your photos aren't posted with this question, so I can't comment on the diagnosis.  Congenital eyelid ptosis is not "normal" or all that common, but it certainly does happen.  To be clear, ptosis means "low" and you can have eyelid or brow ptosis.  Eyelid ptosis should not affect your vision unless the eyelid is so low that it covers your pupil or blocks your peripheral vision.  In other words, eyelid ptosis doesn't change the way your eyeball functions or "focuses on" the world around you.  It won't make you need contacts or glasses, and won't change the results of the eye exam an optometrist does.  An ophthalmologist (MD that takes care of eyes) would be more likely than an optometrist to notice and comment on eyelid ptosis.  The surgery is sometimes covered by insurance.  It is more likely to be covered if it is blocking some of your vision. The test to determine that is called a visual field test, or Goldmann visual field test.  This can be done at an ophthalmologist's office.  If it isn't blocking your vision, your insurance may consider it cosmetic.  It can usually be repaired with a 20 minute procedure that can even sometimes be done right in the office.  Best of luck.

Chase Lay, MD · Answer

U do appear to have congenital ptosis.  If it obstructs your superior and lateral visual fields then your insurance network may cover the surgery to correct this.  Even though you have functions quite well up to this point in your life it will likely progress necessitating surgery eventually.  Consult with an oculoplastic surgeon.

John M. Griffin, MD (retired) · Answer

Dear SandraI recommend that you see a board certified plastic surgeon or opthamologic plastic surgeon to determine whether you actually have eyelid ptosis.  Your pictures don't show enough to make any diagnosis.  A plastic surgeon meeds to examine you personally to determine exactly how much eyelid drooping is present and whether it is bilateral.  Also the surgeon needs to see you to determine the strength of the muscle that lifts your eyelids and whether you would benefit from any surgery.Of course, your optometrist is not qualified to diagnose or deal with these problems.

If I had Congenital eyelid ptosis, wouldn't my Optometrist have diagnosed by now?

Answers (5)

Answer: You do not appear to have congenital ptosis

Answer: You do not appear to have congenital ptosis

Answer: Eyelid ptosis

Answer: Eyelid ptosis

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If I had Congenital eyelid ptosis, wouldn't my Optometrist have diagnosed by now?

Answers (5)

Answer: You do not appear to have congenital ptosis

Answer: You do not appear to have congenital ptosis

Answer: Eyelid ptosis

Answer: Eyelid ptosis

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.