Could bad vision be caused by ptosis and can eyelid filler help? (photos)

Question

Hi so I've had bad vision for a while I'm -3.50 on one eye and 3.25 in the other. I don't wear glasses lately some days I feel I go crosseyed. Could this be connected to ptosis it got really bad this year I don't feel it was like this forever , what do I need?eyelid filler ? Ptsosis surgery ?help thank you

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your picture.  I would recommend a general medical and ophthalmic exam to make sure that there are no underlying medical issues.  If you do not have a medical problem causing your eyelid problem then a ptosis repair would be necessary.  This can be performed by a qualified plastic surgeon or oculoplastic surgeon.  
Best wishes

George Yang, MD · Answer

Hi, You appear to have right upper eyelid/brow fat loss. This is often times seen with ptosis. I can’t tell if the ptosis caused the fat loss or the fat loss causes the ptosis (which came first? the chicken or the egg situation) Does your eyes look more symmetric in the morning when you have more swelling in the eyes? Does the ptosis look better? If so, then #uppereyelidfiller may help you. 
Prior to the progression, of the fat loss/ptosis this past year, younger photos likely showed better symmetry of your eyes. However, upon closer inspection of the younger photos, there is usually evidence that the two eyes look different. Usually one eye shows more eyelid and is the prettier eye, and the other eye is more hooded (less pretty?). Over the years the fat shrinks and difference in the amount of fat reaches a tipping point and the upper eyelid becomes noticeably hollowed. This causes the skin to get sucked into the hollow and for some people they feel that the eyelid skin is getting trapped between the eyeball and the brow bone. This can feel uncomfortable and cause them to raise their eyebrow to make the feeling go away. Targeting the volume loss can help improve the symmetry of multiple areas: brow fullness, which covers some of the eyelid platform (eyelid show). These two factors will the. Look more become more similar to the opposite side. When the brow is fuller and the skin is no longer trapped in the hollow, often times the eyebrow also relaxes and then matches the height of the eyebrow on the other side. If this is achieved, you may still notice that you had a difference the MRD (marginal reflex distance- distance between the upper lid margin to the highlight in the center of your iris; normal range 4-4.5 mm) between your 2 eyes. This may have been present even when you were younger, and the filler will not help with true ptosis. 
 If it is a true blepharoptosis, the levator muscle is stretched or weakened. This prevents the upper eyelid from opening equally to the other side. Fat loss is often times also seen with the ptosis. So the chicken and egg question is whether the ptosis came first which caused the eyebrow to raise, the raising of the eyebrow causes the fat loss? Or does the fat loss cause the ptosis? 
I hope this answer provided some value to you. Good luck with your research on what to do with your eyelids. Best, Dr. Yang

Robert T. Buchanan, MD (retired) · Answer

First, the answer to your question. Filler is definitely not what you need to consider. You have obviously seen an ophthalmologist to know what your visual acuity is. I suggest, however, that you see someone else in a large group with access to specialists in all aspects of eye treatment. You need someone who specializes in treating your vision problems and also an ophthalmic plastic surgeon who can evaluate you for the ptosis. They will need to coordinate their treatment.

Could bad vision be caused by ptosis and can eyelid filler help? (photos)

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Could bad vision be caused by ptosis and can eyelid filler help? (photos)

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