What is a Congenital Ptosis?

Ptosis is the medical term for drooping of the upper eyelid, a condition that may affect one or both eyes. Ptosis that is present since birth is called Congenital Ptosis.

What causes Congenital Ptosis?

While the cause of ptosis is often unclear, the most common reason is improper development of the levator muscle. The levator muscle is the major muscle responsible for lifting the upper eyelid.

Is this condition associated with other eye problems?

Children with congenital ptosis may also have amblyopia (lazy eye), strabismus or squint (eyes that are not properly aligned or straight), or refractive errors (need for glasses).

Is there any treatment for this condition and if so, when is it done?

Congenital ptosis is treated surgically, with the specific operation based on the severity of the ptosis and the strength of the levator muscle. If the ptosis is not severe, surgery is generally performed when the child is between 3 and 5 years (the ‘preschool’ years). However, when the ptosis interferes with the child’s vision, surgery is performed at an earlier age to allow proper visual development.

How is the operation done as a day case?

The operation is usually done under general anaesthetic as a day case. The child will have dissolving stitches at the site of the operation.

What to expect after the operation

A dressing may be applied for 24 hours. Make sure the wound is kept clean and dry. There should be very little discharge from the wound and if necessary, you may clean it using cooled, boiled water and clean cotton wool or tissue. Use a separate piece of cotton wool or tissue for each wipe to the area.

The child will be prescribed some lubricating eye drops and cream along with an antibiotic eye drop – please use as directed.

Are there any risks or side effects?

  • There may be bruising around the eye.
  • There is a small risk of infection of the eyelid or the eye.
  • There is a possibility of under or over correction of the eyelid, which may require further operations.
  • There is a possibility for the child to be unable to close the eyelids permanently.

What are the Benefits?

  • Restoring normal appearance of the eyelid.
  • Improved cosmesis may improve the child’s self-confidence, especially if the child is teased at school.