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  • Chris Thiagarajah MD

How to fix a Child's drooping eyelid



Ptosis in children can be troubling for the child along with the parent. Often, in infancy children do not notice the ptosis or drooping eyelid they have, however as they get older they become more aware of it as classmates in school point it out. For parents, they will be aware of the ptosis in their child from birth. As an oculoplastic surgeon or eyelid specialist I commony treat children and adults for drooping of their eyelids. Ptosis is the main area of focus for oculoplastic surgeons in fact and many books have been written by oculoplastic surgeons on the subject.

What causes ptosis or drooping eyelids in children?

First off, ptosis or drooping of the eyelid in children is usually caused by a weak levator muscle. This is the muscle that primarily is used to lift the eyelid. In babies who have congenital ptosis, often they are born with a maldeveloped levator muscle. This is known as congenital ptosis.

Other types of ptosis that adults usually have are called acquired ptosis. This can have many causes such as weakening of the levator muscle with age, neurological causes, a growth on the eyelid weighing it down etc..

Is Ptosis in my child an emergency?

Ptosis or drooping of the eyelid in children in itself is not an emergency. However, there is one situation where ptosis of the eyelid can be more serious. If the eyelid is so droopy it is blocking the vision of the eye or distorting the surface of the eye so the vision is blurry, the ptosis should be fixed immediately. By age seven, the part of the brain used for seeing fully develops and if the eye is not stimulated to use vision it does not develop properly. These patients need to have their eyelids fixed immediately.

What are the different ways that ptosis in children is fixed?

There are several approaches to ptosis in children. First off, if the muscle has some strength to it, it can be tightened. In adults, this is done with the patient awake but in children this is done with them asleep because they would not do well in the operating rom awake during a surgery.

The second approach is with a sling. A ptosis sling is made of either silicone or the patient’s own tissue and is used to lift the eyelid from the eyebrow. There are three incisions made in the eye brow and one on the eyelid crease for placement of the sling.

What are the risks of ptosis surgery in children?

For ptosis surgery in children, it is possible the child may need further surgery as they grow. Also the initial surgery may not work all the way or may raise the eyelid too high. Any surgery on the eyelid carries a risk of vision loss, double vision, dry eye, need for more surgery. It is generally a process to get the child to where they need to be over time.

How do I find a ptosis surgeon or drooping eyelid surgeon?

Eyelid or Oculoplastic surgeons such as myself are members of the American Society of Ophthalmic Plastic Surgeons (ASOPRS). You can look on their website to find someone qualified. The most important thing is the connection between the surgeon and the patient. Go to someone who is experienced, you feel good with and will be available if there is a problem. If you are in the Denver area you are welcome to make an appointment to see Dr Thiagarajah an ASOPRS oculoplastic surgeon.Good luck on your child’s drooping eyelid.


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