Doctor doesn't think this is ptosis, but rather a lack of an eyelid crease - advice? (photos)

Question

A few years ago I noticed my eyelid progressively getting more asymmetrical compared to my right. My doc says it is not noticeable but for me the asymmetry is ther and I disagree that it isn't noticeable. He did the necessary measurements and found just a 1mm drooping of the left lid, and said the aperture of the eyelids itself is quite symmetrical, but rather the eyelid CREASE is missing on the left hand side. Any ideas on what to do? It is frustrating, I would like my old eye back lol

Ayse Dolar Bilge, MD · Answer

Upper eyelid filler can help your problem as you don't have significant ptosis. Best regards ...,Dr Ayse

C. Blake Perry, MD · Answer

You do have ptosis of the left upper eyelid. With that ptosis comes an elevated eyelid crease. Ptosis repair with a crease formation will improve the symmetry. Best to see an eyelid expert.

Nancy de Kleer, MD, FRCSC (Plast) · Answer

In the photos it appears you have some mild ptosis.
I recommend you be evaluated by an occuloplastic surgeon.
All the best to you.

Mark L. Mazow, MD, FACS · Answer

I think you do have ptosis of your left upper lid. The lid crease is high, the margin Reflex distance is lower and your brow is higher on that side. I'm interested to see how the lid would react to a Neo Synepherine test. My guess is that it would assume a more normal position and the crease would normalize. I would get a second opinion from a fellowship trained oculoplastic surgeon

Robert T. Buchanan, MD (retired) · Answer

It is always difficult to make a diagnosis simply from the pictures.  However, it appears that you have disinsertion of the levator, the muscle that holds the eyelid up and elevates it, from the tarsus, the cartilaginous plate near the border of the eyelid.  This has caused ptosis.  There is also caused your eyebrow to elevate trying to elevate your eyelid.  You need to see a plastic or ophthalmic plastic Surgeon who specializes in treating upper eyelid ptosis.

Doctor doesn't think this is ptosis, but rather a lack of an eyelid crease - advice? (photos)

Answers (5)

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