Traumatic Ptosis Treatment

I am a 41 year old/F. At 17, I was in an automobile accident & hit the windshield. No seatbelt. Two years later (what can I say- I was young and didn't learn my lesson), sim. accident. Both eyelids needed stitching. My right eye, has started to droop more and more. I had an eye exam and he commented on it and also said I had cataracts starting and astigmatism (aside from my near sightedness I knew about). Can it hurt me to wait on surgery? or will the continued drooping cause more problems for my eyesite? Thx!

Doctor Answers 5

Drooping can cause problems

The drooping causes problems because it occludes your vision but it does not interfere with eye function. It usually changes gradually and can usually be repaired with surgery. 

Newport Beach Plastic Surgeon
4.4 out of 5 stars 27 reviews

Traumatic ptosis

It is apparent that the injury severed or weakened the Levator aponeurosis or muscle blanket that lifts the eyelid and it should be repaired at some point. The condition will only get worse with time and it may impair your field of vision. Oculoplastic and some Facial Plastic and Plastic surgeons perform this procedure, but experience varies, and results may not be perfect in any case.

Harrison C. Putman III, MD
Peoria Facial Plastic Surgeon
4.7 out of 5 stars 13 reviews

Correction of Droopy Upper Eylids

The upper eyelid is lifted like an awning off the eyeball by a muscle the Levator palpebrae, which attaches from the inner rim of the upper socket and ends as a wide thin tendon (aka Aponeurosis) inserting into the upper edge of the tarsal plate - a thin cartilage stave (stiffener) that spans the width of the lower aspect of the upper lid. As the muscle shortens, the lid is pulled upwards.

Anything that interferes with Levator muscle shortening ( several neurological diseases), or disrupts its aponeurosis from pulling the tarsal plate (trauma, age related thinning and fraying or congenital weakness or absence) will result in sleepy / bedroom eyes.

In your case, the eyelid scars need to be opened and the torn aponeurosis / tendon needs to be repaired. This can be done anytime you are ready. Although you will see a lot better once you have it done.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Hope you have learned the lesson and are wearing the seatbelt!

If the issue is just drooping of the eyelid, then it will not cause a problem with the eyes. However, most people you encounter will be wondering if you are tired, lazy or on drugs, which is why people are motivated to take care of problems like this. Generally these types of problems are covered by health insurance.

I would recommend getting a referral from the ophthalmologist who is following you for the cataract for an eyelid plastic surgeon who accepts your health insurance. If you lack health insurance and are a resident of Los Angeles County, you could seek medical care at a Country Hospital. Harbor UCLA Medical Center has excellent ophthalmic care.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Ptosis surgery is not an emergency

Drooping of your eyelids can act like a shade that blocks some of your peripheral vision. If that is occurring, then there is a medical reason (in addition to the cosmetic reason) to fix your eyelids. However the droopy lid does not damage your eye or vision in a permanent way. For that reason you can wait to have the surgery until you are ready.

Hope this is helpful.

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 24 reviews

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.