Ptosis

Ptosis

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■ Outline:

Ptosis refers to a condition in which the upper eyelid lifting muscles that raise the eyelids are weak and the upper eyelids are lowered and the eyelid crevices are smaller. Patients with ptosis are characterized by having a forehead wrinkle as they lift the eyelids by applying force to the forehead to see the object, because the eyelids are hitting downward to cover the eyes.

There are congenital ptosis and acquired ptosis that occur from birth to ptosis.

■ Definitions:

Acquired ptosis is when the upper eyelid weakens as the age increases and the eyelid falls down. Congenital ptosis occurs when the upper eyelid lift is weaker from birth.

■ Symptom:

If you have ptosis on both eyes, you can not see well, and because it gives strength to the forehead to see the object, it wrinkles on the forehead, both eyebrows rise, and jaws up to see the object with a small eye gap.

■ Causes / Pathophysiology:

cause

The cause of acquired ptosis can also be caused by senility changes, trauma to injury or weakening of the upper eyelid lift, neurological disease, or systemic disease.

Condition

Congenital ptosis is mostly limited to the levator muscle itself, but sometimes it is accompanied by systemic muscle disorders or neurological disorders.

■ Progress / Prognosis:

Amblyopia

Visual acuity begins to develop at the age of 6 to 7 years of age, and the development of the eye is terminated by eye ptosis, which can cause visual impairment and lead to amblyopia. Especially when there is ptosis at a glance. Therefore, severe ptosis surgery should be performed as soon as possible, even if it is young, so that it can develop into sight. Because once you have amblyopia, you will have a life-threatening blindness.

astigmatism

Ptosis can cause astigmatism and can adversely affect a child's vision.

Emotional disturbance

When you play with your friends due to apparent problems, you may feel uneasy and emotional.

■ Complications:

1. Over or under correction

The most common problem after ptosis surgery is the size of the eye after surgery, which may require reoperation. Especially in children, it is difficult to correct the height of the eyes correctly under general anesthesia.

2. I can not fully see my eyes when I sleep

Most patients may present post-operatively, but are often mildly transient. If you sleep with your eyes open during your sleep after surgery, the exposed black pupil may cause scratches and inflammation. To prevent this, eye drops should be used during daytime and artificial leakage ointment at night should be used to prevent eye damage. However, even if it lasts long, it is rarely severe enough to cause eye damage.

3. Eye-level difference when looking down

When you look at the front after surgery, even though it is normal, when you look down, the upper eyelid pulled up by the operation does not go down, and the white part of the eye is visible. Especially, when only one eye is operated, the height of both eyes differs from the bottom. When you look down, you should have a habit of bowing your head so that interpersonal relationships are not hindered.

■ Treatment:

The timing of surgery for congenital ptosis patients may vary according to the extent of the disease. Surgical ptosis that affects the development of visual acuity should be done as soon as possible to aid in the development of eyesight, but in the less severe case, it is a good time to be around 3 ~ 4 years old before entering kindergarten.

Most ptosis can only be treated with surgery. The method of surgery depends on the function of the eye, including eyesight, eye movement, degree of ptosis and function of the levator. The ophthalmologist must thoroughly check before surgery.

The general operation period is determined by the ophthalmologist depending on the degree of ptosis. If you are very serious and think that it can cause disruption of sight development, do surgery as early as possible. If it is not severe, it is usually helpful for emotional problems that you may have to play with your friends when you play before kindergarten or kindergarten.

  

Eyelid lift

This method is performed when the function of the upper eyelid lift muscle remains to some extent. It is a surgical method that shortens a part of the upper limb and strengthens muscle strength, so that the upper eyelid goes up.

Frontal gait technique

It is an operation performed when there is no function of the upper eyelid lift muscle or if it is very weak. This surgery connects the eyelids to the frontal muscles (forehead muscles) and uses the force of the forehead muscles to open the eyes. At this time, surgical materials to connect to the frontal muscle include the muscle membrane of the patient's own leg, artificial muscle membrane, suture, supramid, and silicone. The smallest recurrence rate is the need to have extra muscle surgery on the legs or legs of the patient's own legs.

You can also perform cosmetic surgery including double eyelids to prevent the inside of the eye or eyebrows from drifting inward.

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