Ptosis in a child can produce vision loss because the eye blocked by the lid can not send clear vision messages to the brain.  In such cases, surgery is needed to prevent or reverse vision loss.  Dr. Lichtenstein is experienced in treating ptosis and, of course, the amblyopia that may have resulted prior to treatment. 

About Ptosis
Ptosis (eyelid droop) in infants and children typically occurs because of abnormal development of the muscle that lifts the eyelid.  This is not typically associated with any other muscular abnormalities.    One of the hallmarks of congenital ptosis is that the affected lid doesn’t come all the way down when a child looks down—it “lags” behind the normal lid in a relatively elevated position.    Also, the upper eyelid crease is not as well defined in people with congenital ptosis -- the ptotic lid is relatively "smooth" as compared to the normal one.

When should ptosis be fixed?
Ptosis can cause amblyopia if the lid completely covers the pupil.  In these cases, the ptosis should be repaired as soon as possible so as to prevent worsening of the amblyopia and allow for its treatment.  Another indication for surgery is if the ptosis is causing enough astigmatism to produce amblyopia.

If the ptosis is not severe enough to cause amblyopia, it is often best to wait until a child is 4 or 5 years old before surgical repair.  Waiting until this age allows for more facial development to occur and permits the use of different, more long lasting surgical materials. Also, children under this age are usually indifferent about their eyelid appearance and are unlikely to be teased by other children.

Can ptosis be repaired with just one surgery?
This depends on the surgical technique and materials used to raise the eyelid. What’s more, everybody heals differently.  While some children require just one surgical repair, some need a second operation after variable periods of time.   It is impossible to absolutely predict who will need more than one surgery and the interval between surgeries.  Basically, some children need just one repair, but others need several.   Of course, the surgeon strives to achieve a cure with just one operation.