DescriptionPtosis, pronounced toe-sis, is the medical term for drooping of the upper eyelids. The droopy eyelid can be mild to severe. People who have ptosis may complain that people tell them they look ‚Äútired or lazy.‚Ä? Because of a constant effort to raise the eyelids it is not uncommon to also complain of fatigue and tension headaches.
The most common reason for ptosis is acquired ptosis , which develops as we age. This is due to disinsertion of the tendon that holds the eyelid up in a normal anatomic position. Another cause is congenital ptosis , which happens when a child is born with droopy eyelids. This is rather an urgent medical condition for the child and surgery may be needed to prevent permanent loss of vision in the affected eye. Other rare causes of ptosis include myogenic ptosis from conditions such as Myasthenia gravis, neurogenic ptosis , due to third nerve palsy and mechanical ptosis from tumors or trauma.
In children the procedure is performed under general anesthesia. In adults most eyelid surgery can be performed under local anesthesia. If desired, local anesthesia with sedation can be performed. This type of anesthesia, also known as Monitored Anesthesia Care ( MAC ), is performed by an anesthesiologist. The main advantages of this anesthesia are: (1) it does not require putting a breathing tube in the throat, (2) it does not require a breathing machine, (3) the recovery is much faster, (4) there is less nausea after surgery. All of these elements translate into greater comfort and safety.
During MAC anesthesia, an intravenous needle is placed into one of the veins of the arm or hand. Relaxing medication is given to make the patient fall asleep. The amount of medication is adjusted as needed. After the patient is asleep, numbing medicine is placed in the skin of the area that is being operated on. During the procedure the patient is unaware of anything going on and cannot hear anything, yet he or she is breathing normally.