When a child's eyelid droops, she has a condition referred to as ptosis, and the prolapse can last a lifetime. When a child is born with this condition, the eyelid is mostly stable and will not worsen throughout her life. The eyelid is unlike any other part of your child's body as it has no subcutaneous fat and is among the thinnest layers of the body. The eyelid functions to bind the muscles that surround the eye so repair of your child's drooping eyelid may be necessary.
Cause
Ptosis can occur due to abnormal development of the levator muscle, which is responsible for elevating the eyelid. When this muscle does not develop during gestation, the eyelid has a loss of lifting ability. Muscle diseases and neurological problems can cause ptosis in children, as well as infections or tumors of the eyelid.
Effects
Children who have ptosis are at risk for deficits in peripheral or central vision. As your child ages, he may experience self-esteem problems once he realizes his eyes look different than his peers'.
Diagnosis
When determining the severity and reason for your son's ptosis, the doctor will review any symptoms she may have that accompany the eyelid droop. Doctors look for signs of double vision, muscle weakness, swallowing and speech difficulty, headache or tingling sensation on any part of his body. The doctor should delve into your family history and look for relatives who have ptosis or other muscle disorders. Your child will most likely undergo a physical, neurological and eye exam that may encompass a magnetic resonance imaging, or MRI, scan as well as a computed tomography, or CT--"CaT"--scan.
Treatment
Surgical repair by shortening and strengthening the levator muscle is an effective therapy for ptosis. Surgery will usually be postponed until your child is between the ages of 3 to 5 years old, if ptosis does not impair vision. However, if vision is affected, corrective surgery is best done as a newborn, as early treatment reduces the risk of permanent damage to vision. Surgery may not be recommended if your child's ptosis is caused by a muscle disease, neurological problems or local eye problems. Your child's doctor may want to treat the contributing illness first, which may correct the ptosis.
Warning
Corrective surgery for ptosis caries a risk of contour abnormality, over-correction or under-correction of the eyelid. Over-correction may be resolved by massage or suture adjustment, but repeat surgery may be necessary for any non-successful surgical correction. If postoperative keratitis occurs with the levator muscle repair, artificial tears and ointments will be prescribed for eye lubrication.
