Ptosis - causes and signs of ptosis

By etiology (cause) there are:

• congenital ptosis;
• acquired ptosis.

By severity of ptosis:

• partial ptosis;
• incomplete ptosis;
• complete ptosis.

Causes:

Ptosis occurs when the normal functioning of the muscle that raises the upper eyelid, which is innervated by the oculomotor nerve (3rd pair of cranial nerves), is disrupted.

• These disorders can be congenital during pathological birth or with intrauterine developmental disorders.
• The muscle that raises the The upper eyelid can be damaged by traumatic processes, after surgical interventions on the face, due to the development of scar tissue that interferes with the full functioning of this muscle.
• Neurological pathology: stroke or a focus of demyelination in the area of the brainstem, where the nuclei of the oculomotor nerve are located, as well as damage to the peripheral part of the oculomotor nerve outside the brainstem. With myasthenia, ptosis will be observed, complete or partial, towards the evening.
• Age-related weakening of the aponeurosis and the muscle that lifts the upper eyelid, which is observed in older people.

Symptoms:

• When the patient consults a neurologist, in addition to drooping eyelids, he may present other complaints in the form of double vision when looking in different directions (diplopia), especially when the patient looks at his nose.
• If ptosis is associated with myasthenia, then by the evening the patient complains of increased fatigue of the eyeballs.
• If the patient does not seek medical help and treatment for a long time, then deterioration of vision (amblyopia) or narrowing of the visual fields develops.
• If there is damage to the oculomotor nerve, then in addition to ptosis, the doctor during an objective examination discovers divergent strabismus, pupil dilation, decreased or absent direct and consensual pupillary response to light, and accommodation paralysis.
• Ptosis complications may include inflammation of the conjunctiva and cornea.

If a patient with ptosis does not seek medical help for a long time, he develops a specific facial expression with a wrinkled forehead, due to the deliberate raising of the upper eyelid by the eyebrows and a constantly raised head to increase the field of vision.

Diagnostics:

Diagnostics involves interpreting complaints, questioning, and examining the patient by a neurologist. During the examination, the doctor conducts many tests to identify the underlying cause of the disease. To clarify the diagnosis and differentiate it, the doctor prescribes additional research methods: CT (computer tomography) of the brain, MRI (magnetic resonance imaging) of the brain. To undergo additional research methods, you must make an appointment with a functional diagnostics doctor.

For more detailed information on the diagnosis and treatment of ptosis of unknown etiology, you must make an appointment with a neurologist. A consultation with a neurologist allows you to establish a diagnosis, prescribe treatment, restore lost function and eliminate unpleasant sensations associated with strabismus, double vision and other unpleasant sensations with ptosis of the upper eyelid.

Treatment:

Treatment for ptosis is started only after a thorough and complete examination. The appropriate treatment is prescribed by a neurologist.

• In case of damage to the aponeurosis or the presence of congenital ptosis, they resort to surgical intervention by microsurgery (plastic surgery). The operation is minimally invasive and is performed under general or local anesthesia.
• If there is a neurological pathology, then the underlying disease that caused ptosis (stroke, multiple sclerosis, myasthenia) is treated. It is applied.

Prevention:

• timely detection of ptosis;
• conduct a thorough examination of pregnant women;
• careful and low-traumatic management of childbirth;
• healthy and sound sleep;
• do not abuse alcohol and drugs;
• do not take unknown medications and do not change the dose prescribed by the doctor;
• work and rest schedule;
• regular physical activity;
• occupational hygiene;
• rational nutrition;
• timely treatment of diseases causing ptosis (monitoring of blood pressure figures pressure);
• rational management of postoperative wounds.