Ptosis in Children
What is it?
Ptosis is an eyelid malposition that refers to the dropping of one or both upper eyelids causing visual axis occlusion to greater or lesser extent. There is no specific age for developing this condition, as it can occur both in children and adults. However, children often show symptoms of ptosis from birth, since in most cases has a purely congenital cause. Therefore, while in adults ptosis is usually acquired due to multiple causes (aging, trauma, muscle diseases or neurological disorders) in children is present from birth (congenital ptosis) and usually, it is related to poor development of the muscle that is responsible for raising the eyelid (idiopathic isolated dysgenesis of the levator muscle of the upper eyelid, is the most common cause of ptosis in children).
The symptoms caused by this defect can vary, depending on whether the case is mild, moderate or severe. Basically, it is considered that the ptosis is mild when the lid covers only the top of the pupil; it is a severe case when the lid fully occludes the visual axis, keeping the affected without activity, because the pupil has been completely covered by the droopy eyelid. This fact in children can lead to amblyopia, or lazy eye.
Treatment of congenital ptosis essentially depends on the patient's age, his/her vision and muscle function. In mild cases, in which the droopy eyelid does not cover the pupil, often ptosis correction is not necessary. In contrast, eyelid correction when the lid covers the visual axis, is necessary as soon as possible to ensure proper visual development. Therefore, in all cases we must determine the visual acuity and refractive error. If there is a risk of amblyopia by occlusion of the visual axis surgery should be performed early. As for the different surgical techniques to correct ptosis, choosing one or the other will depend on muscle function.
At the Barraquer Ophthalmology Centre we recommend that if there is any suspicion of eyelid malposition in children, a specialist ophthalmologist should perform the first assessment of visual acuity and discard any anomalies that may affect the vision "learning" and lead to lazy eye.
It is important that all patients are assessed by ophthalmologists specialists in this pathology when palpebral alterations occur. Moreover, in the case of children when vision may be compromised.