Ptosis surgery failure ? Eyes too tight.

Question

Hi, I had ptosis surgery 6 weeks ago on my right eye. I think the doctor took too much skin from my eyebrow. I was born with the droopy eye so he tighten some of my eye muscles. I think he did it too tight, I can not close my eye it is half way open and it dries out ALL the time. I can not look up all the way and when I look down it looks like that eye is still looking up. I can not blink either. My doctor says it is fine, but I am soo scared it this normal? How am I ever going to close my eye again?

John J. Martin, Jr., MD · Answer

For most patients with congenital ptosis, the levator muscle is not like a normal muscle.  So when we perform surgery to elevate the lid, it will usually not close normally again.  If the surgery is done at a young age, the cornea will adapt to the exposure.  If done later in life, the cornea often does not tolerate the dryness and you will need to use frequent lubrication to keep the cornea healthy.  If a patient can not tolerate the dryness, the lid will have to be lowered.  You need to make sure that an oculoplastic surgeon is handling your surgical concerns.

Mehryar (Ray) Taban, MD, FACS · Answer

Congenital ptosis surgery is one of the most difficult and frustrating procedures due to the inherent problem with the weak muscle. It is very difficult to acheive a balance between eye opening and eye closure but a happy medium is possible, but it may require more than one procedure. See an oculoplastic surgeon.

Kenneth D. Steinsapir, MD · Answer

Opening the eyes in the setting of congenital ptosis is a balance.  Too open and there are chronic corneal exposure issues, i.e. unable to close or blink the eyes close.  Adults do not tolerate this situation very well.  Not open enough and you will feel like the surgery did not accomplish enough.  I strongly encourage you to seek second opinions.  The surgery should be done by a very experienced oculoplastic surgeon.  Consider seeing an academic based oculoplastic surgeon for a second opinion.  A cornea specialist can also assess if the eyelids are properly protecting the corneal surfaces.  These are always difficult situations.

Ptosis surgery failure ? Eyes too tight.

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Ptosis surgery failure ? Eyes too tight.

Answers (3)

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