I am 15 and have congenital ptosis where left eyelid droops lower than my right eye and doesn't blink. I have had 3 surgeries but is still very unhappy with the way i look. I went to an eye surgeon wondering if it would be possible to droop my right eyelid he said it is to big of a risk and why mess something up that is fine. I was wondering if there is any options for me so my other doesn't blink so it would make it less noticeable and maybe droop it?
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Doctor Answers 4
I would recommend that you be very careful with this
The eyelid that has the congenital ptosis has an abnormal muscle that did not form normally. Normal muscle development is essential to have a normal appear eyelid. Generally there is no perfect solution to these problems. I would recommend that you avoid general ophthalmolgists who mean well but lack the proper expertise to help you. In your area, I would recommend that you see Peter Dolman.
Congenital ptosis can be very tricky -- choose wisely
As others have suggested, unilateral congenital ptosis is a very challenging entity.
It is too complicated to give clear advice without a thorough examination.
I agree with the other suggestion that you visit Dr. Peter Dolman in consultation. He is a very experienced, skilled, honest and personable oculoplastic surgeon.
Mark Lucarelli, MD, FACS
There are various techniques to correct ptosis, depending on the strength of eyelid muscle, amount of ptosis, and if you have had previous surgeries. Lowering the other side is an option, but not a good one. It is best to elevate the ptotic side.
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Congenital ptosis has limitations to adapt to
Upper eyelid ptosis has many causes. However, the root cause is improper function of a muscle called the levator which works to lift the eyelid much like a window shade. In congenital ptosis, at birth the upper eyelid will droop and can cover a portion of the pupil because the muscle is not working completely. The success of the repair will depend on the degree of function which is present, the more motion in the lid the more symmetry and control. The repair looks dynamic (moves) and natural. The less motion the repair becomes static (stays open) and will not blink.
Ptosis repair requires compromise in that we wish the eye open well enough to see and look symmetrical, though we know that the muscle does not function to the full extent that it should. Producing a droop in the 'good' eye for symmetry is never a good option as we can reduce useful vision. The 'best case under the circumstances' repair on the 'bad' eye is best, with drops or corneal protection for wind or abrasion. Your eyes will always appear best when you smile.
Best of luck,
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.