Young Son w/ Congenital Ptosis - Has Surgery Failed?

He had surgery to correct the ptosis in August 2010 at 17 months old. He was unable to close his eye after surgery. But as the swelling went down and with time his eye started to close more. To it only being slightly open when he was asleep. He has to have 2 hourly drops in his eye. I have noticed recently that his eye appears to be drooping more and his pupil is half covered most of the time. It is worse when he is tired. has the surgery failed? It is only his left eye that is affected.

Doctor Answers 5

Ptosis of eyelid in your child is a complex problem.

   The surgery has absolutely not failed but please realize that this is one of the most complex and sifficult problems in plastic surgery.  Patients with congenital ptosis often undergo many surgeries befor a pleasing reslut is attineed.  Just be confident that a pleasing result is possible and will be attine for your son.  There are many possible procedures and I recommend you see two opthalmic plastic surgeons and two ABPS-FACS surgeons for opinions. Do nt rush. Go to a major University Service.  Do you homework.  Make sure your surgeon does this weekly and make thwem prove it.  If you are not accommodated, walk out.   Your son will be fine.  Ideally at his next surgery, a team of both opthamic surgeon and plastic ABPS surgeon will be in attendance.  This is WHAT I WOULD INSIST ON FOR MY SON!   BOTH WORK TOGETHER.  YOUR HARD RESEARCH AS TO WHO IS THE BEST IN YOUR AREA WILL BE REWARDED.  Do not dispair.   It will take 3 or 4 more surgeries to hit perfection at age 19 but YOU WILL AND CAN GET THERE.   My Best.    Dr Commons.

Congenital ptosis

It appears there is still ptosis present.  It is possible that the surgery has failed. (If it was originally a frontalis sling procedure, sometimes the sling breaks.)  Recommend consultation with an oculoplastic surgeon.

Dr Taban

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 62 reviews

Congenital Ptosis

It depends on the type of surgery he had, but it looks like he had a frontalis sling procedure based on the immediate post-op photo. With that type of surgery, when your son is not using his eyebrow muscle to open the eyelids, the eyelid will still seem droopy. The goal of the surgery is to set the eyelid slightly above the pupil at baseline so that when he uses his eyebrows as most children with congenital ptosis do, he can see better. The eyelid cannot be opened widely without eyebrow use because there would be risk of damage to the eye itself. Once he raises his eyebrow, you should notice a significant change in the eyelid position. If it still looks the same even if he uses his eyebrow, I would suggest seeing an oculoplastic surgeon as he may need a revision.

Mahsa Sohrab, MD
New York Oculoplastic Surgeon

Congenital Ptosis - Often Requires a Seconday Surgery

It is quite possible that significant improvement occurred from her first surgery despite the fact that a total correction is still not present. Close and continued followups are required with your pediatric plastic surgeon for oculoplastic surgeon. When in doubt seek a secondary consultation. Oftentimes more than one surgery is required for the best results.

It is a normal effect of ptosis surgery not to be able to close the eye completely

It is a normal effect of surgery not to be able to close the eye completely. It often gets better with time but may be a permanent side effect to the surgery. It is not usually dangerous or harmful in children. Usually it is a good trade off for having the lid higher, particularly if the eyelid is blocking vision. But, you should go back to your doctor to make sure there is no problem.. It often gets better with time but may be a permanent side effect to the surgery. It is not usually dangerous or harmful in children. Usually it is a good trade off for having the lid higher, particularly if the eyelid is blocking vision. But, you should go back to your doctor to make sure there is no problem.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 64 reviews

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