Drooping eyelids (medically known as "ptosis") refer to the lowering of the upper eyelid, which partially or completely covers the upper edge of the pupil, and may affect vision, aesthetics or eye function. Knowing whether ptosis exists and determining its degree and type are important for daily health management and medical intervention.
1. Definition and classification of ptosis
Ptosis is a common eyelid position abnormality characterized by the upper eyelid edge being lower than the normal anatomical position. Normally, the eyelid edge should be located approximately 1 to 2 mm above the corneal edge. If it is lower than this position, especially when it covers part or all of the pupil, it is considered ptosis.
Based on the cause and pathogenesis, ptosis can be divided into the following categories:
Congenital ptosis : present at birth, mainly due to hypoplasia or dysfunction of the levator palpebrae superioris muscle.
Acquired ptosis : occurs in adulthood and is further subdivided based on the pathogenesis:
①, 3. Neurological: such as oculomotor nerve palsy, Horner's syndrome, etc.
②, 4. Myogenic: such as myasthenia gravis, muscular dystrophy, etc.
③ 5. Mechanical: such as eyelid tumors, scar traction, etc., which lead to increased eyelid weight.
④, 6. Traumatic: such as damage to the levator palpebrae superioris muscle or its aponeurosis after eyelid surgery or trauma.
2. How to self-diagnose whether there is ptosis
Judging ptosis is not complicated, but it requires a combination of multiple observation indicators and simple self-examination methods.
Observe in front of the mirror : Stand in front of the mirror, relax your face, and look straight ahead naturally.
①, 2. Observe whether the upper eyelid margins of both eyes are symmetrical.
②, 3. Determine whether the eyelid margin is 1-2 mm lower than the upper edge of the pupil.
③、 4. Pay attention to whether there is difficulty opening one eye or obvious difference between the two eyes.
Photo comparison : Take a photo with your phone from the front and compare the height of eyelid opening and closing.
①, 6. You can use a ruler or drawing tool to compare the height of the palpebral fissure (the distance between the upper and lower eyelids).
②, 7. If one side is significantly lower than the other, it indicates possible ptosis.
Look up and observe :
①, 9. Do you often have the habit of looking up at people or raising your eyebrows when looking at things?
②, 10. These compensatory movements are the body's way of expanding the field of vision and alleviating the effects of sagging.
Are there other symptoms :
①, 12. If you have blurred vision, fatigue, abnormal eye movement, enophthalmos, etc., it may indicate ptosis caused by neural or muscle factors and should be taken seriously.
Muscle strength test with eyes closed and eyes open :
①, 14. Close your eyes and then suddenly open them to see if it is strenuous or if the range of eye opening is limited.
②, 15. You can observe the degree of eyelid lifting in conjunction with the eyebrow lifting movement to see if there is any slowness or weakness.
3. How to diagnose ptosis through medical examination
If you suspect ptosis through self-observation, it is recommended to go to the hospital's ophthalmology or plastic surgery department for professional evaluation. Routine examinations include:
Palpebral fissure height measurement (MRD1) : Measure the distance from the center of the pupil to the upper eyelid edge. The normal value is 2.5 to 4.5 mm. If it is less than 2 mm, it indicates ptosis.
Assessment of levator palpebrae superioris muscle function : Observe whether the range of motion of the levator palpebrae superioris muscle is normal (normal is more than 12 mm) when opening the eyes after closing them.
Corneal reflex positioning : assists in determining the relative position of the eyelid margin and corneal light reflection point.
Neurological signs : Assess whether there is oculomotor nerve dysfunction.
Myasthenia tests : such as the ice test or neostigmine injection, are used to determine whether the ptosis is caused by myasthenia gravis.
Imaging examinations : such as MRI or CT are used to exclude causes such as cranial neuropathies and orbital tumors.
4. Functional effects of ptosis
Drooping eyelids not only affect appearance, but may also have adverse effects on daily life:
Blocked visual field : When the upper eyelid covers part of the pupil, the patient needs to raise his head or eyebrows to compensate for the loss of visual field, which can cause fatigue of the neck and forehead muscles over a long period of time.
Visual fatigue : Especially when combined with decreased vision in both eyes, patients are prone to symptoms such as headaches and decreased concentration.
Risk of amblyopia : If a child suffers from congenital ptosis, long-term covering of the visual axis may induce unilateral or bilateral amblyopia.
Dry eyes or conjunctival exposure : Excessive ptosis will affect the normal eye closing function, causing conjunctival dryness or corneal exposure inflammation.
5. When should you consider seeking medical treatment?
If any of the following situations occur, you should seek medical attention immediately:
①. Obvious unilateral or bilateral eyelid ptosis, affecting normal vision.
②. Sudden ptosis, accompanied by neurological symptoms such as diplopia, eye movement disorder, headache, etc.
③. It is difficult to keep your eyes open for a long time, which affects daily functions such as reading, driving, and communication.
④. Children suffer from congenital ptosis, which blocks the pupil or is accompanied by abnormal eye position.
⑤. The drooping gradually worsens or is accompanied by symptoms of general muscle weakness.
6. A brief introduction to common treatments for ptosis
Different types and degrees of ptosis have different treatment methods, and intervention should be carried out based on the clear cause:
Drug treatment : Applicable to myogenic diseases such as myasthenia gravis, anticholinesterase drugs are used to relieve symptoms.
Neurogenic ptosis : For example, in cases of oculomotor nerve paralysis, treatment is mainly based on the cause, such as antiviral and neurotrophic treatments.
Surgical intervention : For structural, congenital or aponeurotic ptosis, eyelid reconstructive surgery such as levator palpebrae superioris aponeurotic repair and frontalis muscle suspension is often chosen.
Auxiliary corrective devices : Some mild patients can use eyelid supports or special glasses frames for temporary functional compensation.
Beauty Encyclopedia Tips:
Although ptosis is not life-threatening in most cases, it has a significant impact on appearance, visual function and quality of life. Self-judgment combined with professional evaluation can help with early detection and scientific intervention. If there is abnormal eyelid position or difficulty opening the eyes, you should avoid blindly using massage, ointments and other methods, and choose a regular medical institution for examination and treatment, especially for pediatric patients. Delayed diagnosis and treatment may affect vision development. It is recommended to consult a professional doctor as soon as possible and establish long-term follow-up observation.