In a normal state, the human face is relatively symmetrical on the right and left sides. If on one or both eyes the iris is covered more than 1,8-2 mm, ptosis of the upper eyelid (descent) takes place. This pathology arises from various acquired factors, and also is congenital.
Causes of ptosis of the upper eyelid
In order to determine the source of the development of the disease, it is important to know its classification.
Congenital ptosis, as a rule, bilateral, arise due to the following factors:
- Blepharophimosis. It is characterized by genetic pathology, which is accompanied by an abnormally short eye gap, as well as underdeveloped muscles of the upper eyelid. It is worth noting that the lower eyelid is often turned out.
- Incorrect functioning of the nucleus of the oculomotor nerve. As a result, the eyelid is constantly lower than it should be.
- Inheritance of an autosomal dominant gene, which provokes an underdevelopment of muscle tissue to raise the upper eyelid.
- Palpebromandibular syndrome. The disease is characterized by the connection of the trigeminal nerve with the muscle, which is responsible for the ascent of the eyelid. In a calm state it is omitted, but during chewing it rises. As a rule, this syndrome is accompanied by amblyopia and strabismus.
More common is the acquired form of the disease. Its reasons:
- Myasthenia gravis (fatigue of muscles). The omission of the eyelid is observed with visual loads, its severity changes with the progression of pathology.
- Mechanical shortening of the century. It happens because of tumor processes, tissue scarring.
- Side effects of some types of plastic surgery and cosmetology, for example, ptosis of the upper eyelid after Disport or Botox . Appears as a result of incorrectly selected points for injection, exceeding the recommended dosage, injecting the drug too close to the eyebrows.
- Separation of the tendon of the motor muscle of the eyelid from the plate to which it is attached. Usually affects people of advanced age or those who have a serous eye injury.
- Paralysis of the oculomotor nerve, arising from intracranial aneurysms, diabetes mellitus, tumors.
In addition, the described disease can be:
- full - the eyelid completely closes the pupil;
- incomplete - the line of the eyelashes is located in the middle of the pupil;
- partial ptosis of the upper eyelid - the pupil is covered by a third.
Also, this classification characterizes the stage of pathology, which describes visual acuity. With a severe degree (complete ptosis), the ability to see normally gradually decreases.
How to treat the ptosis of the upper eyelid?
The only effective method of therapy is surgical correction. Conservative elimination of ptosis of the upper eyelid is carried out only in the case of neurogenic causes of the disease. It consists in the restoration of nervous functions with the use of UHF and galvanotherapy, mechanical fixation.
Surgical intervention and tactics of its management depend on the form of pathology.
Treatment of ptosis of the upper eyelid by the operation
If the disease is congenital, the procedure consists in shortening (plication) of the muscle, which raises the upper eyelid. Sometimes it is sewn to the frontal muscle, when the ptosis is complete. The wound is sealed with a cosmetic continuous seam.
Acquired disease involves shortening not the muscle itself, but its aponeurosis, after which it is sutured to the lower cartilage of the eyelid (tarsal plate). With mild forms of ptosis, this operation can be performed simultaneously with blepharoplasty . After surgical intervention the patient is quickly restored - within 7-10 days.