Reasons for eye surgery
There are several causes for eyelid ptosis. Most commonly this occurs when the muscle that opens the eyelid stretches out too much and becomes detached. Risk factors are heredity, contact lens wear, chronic eye rubbing, and older age.
Some children are born with this condition due to an eyelid muscle that does not develop or work normally because the muscle fibers themselves are abnormal.
Rare causes of a droopy lid include trauma or tumors pressing on the nerves that send signals to the muscle.
A droopy lid can be repaired with surgery to tighten the eyelid muscle. When mild, this surgery is not covered by insurance. When severe, this surgery may sometimes be covered by insurance if the position of the eyelid blocks vision to a certain degree.
An office test called a visual field is used to demonstrate the visual blockage. Photographs are taken to document how far the droopy lid is covering the eye and pupil.
What to expect after eyelid ptosis repair
Because the eyelid skin is so thin, the incision typically heals as a very fine line. It is placed in the natural crease hidden by the eyelid fold. In some people, the outer part of the incision may be visible, but typically blends well into smile lines or crowsfeet. Sometimes the surgery can be done from the inside of the eyelid, thus avoiding a skin incision altogether.
Eyelid ptosis repair can be performed with local anesthesia in the office, or under sedation. To keep bruising and swelling at a minimum, patients should stay home for 2-3 days after the procedure in order to frequently apply soft, lightweight, cold compresses to the eyelids. Sleeping with the head elevated in a recliner chair also helps prevent additional swelling.
It usually takes 1 to 2 weeks for the bruising to disappear completely, although some persons with certain medical conditions may take longer.
Physical activity should be limited for the first week in order to prevent bleeding. Sutures are removed at one week. Contact lens wear should be avoided for the first 2 weeks.
Vision may be blurry for the first week or two due to antibiotic ointment and eye drops, and incomplete blinking caused by swelling. Once all swelling resolves, blink function returns to normal.
Final results can be seen as early as 3-4 weeks, but in some patients may take 3-4 months, when the swelling fully resolves and the incision softens completely. Healing progress depends a lot upon adherence to postoperative instructions as well as individual health status.