Text author: Dr sc. Bojan Kozomara, dr med.
Ptosis is a medical term that refers to drooping eyelids, meaning eyelids that are not in their normal anatomical position on the eye. If it is a minor degree of ptosis, it is considered purely cosmetic, but if the eyelid is droped to the extent that it covers the pupil and interferes with the vision of the affected eye, then it is termed functional ptosis.
This condition can occur at any stage of life, even at birth, when it is often referred to as traumatic ptosis, which can occur during childbirth. On the other hand, acquired ptosis occurs as a result of injuries or degenerative changes in the muscles or tendons of the eyelids caused by aging, as well as damage to the cranial nerve that lifts the eyelid.
Ptosis can only be corrected surgically, regardless of the patient’s age. Depending on the degree of ptosis and the patient’s age, the technique may involve shortening the tendon of the eyelid elevator muscle or fixing an elastic silicone strip under the skin to the frontalis muscle.
Regardless of the technique used to correct ptosis, all procedures are performed under local anesthesia, without the need for general anesthesia, except in cases where ptosis correction is performed in children, and then surgery under general anesthesia is advised.
Patients typically recover within 7-10 days, after which the full effect of the surgical procedure can be seen.
Due to changes in the tissue structure of the eyelids, often caused by aging, but sometimes also by scars or nerve dysfunction, conditions of eyelid malposition occur, namely the turning outward of the eyelid (ectropion) or inward (entropion).
The development of ectropion is often accompanied not only by poor eyelid aesthetics but also by chronic irritation of the conjunctiva (conjunctivitis) and inflammation of the cornea (keratitis). The reason for the development of these conditions is the inability to retain tears on the surface of the eye due to the disrupted eyelid position, which reduces or completely nullifies the protective function of the tear film.
Unlike ectropion, entropion involves the inward turning of the eyelid. Patients often complain of eye irritation and vision impairment, which can be caused by epithelial damage on the cornea (epithelial erosions) or inflammation caused by eyelash contact with the cornea.
After removing excess skin, the incision is closed with sutures that may be self-absorbing and do not need to be removed after the surgery, or with non-absorbable sutures that need to be removed 7-10 days after the procedure.
During the postoperative period, which typically lasts about 7 days, patients are advised to apply cold compresses to the eyelids several times a day (usually using ice) and to rest more for the first two days after the procedure, avoiding strenuous physical activity.
Postoperative follow-up appointments are often not necessary.
Surgical intervention in both cases is simple, quick, and effective. It strengthens the eyelid muscles and restores the eyelid to its normal anatomical position.
Regardless of the technique used, all procedures are performed under local anesthesia, and the patient can return to their daily activities within a few days.
