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Ptosis, or blepharoptosis, is an upper eyelid condition that, as well as causing a lack of confidence in some people, can develop to the point where it affects people’s field of vision.
Thankfully, it’s possible to fix it in the hands of a highly-trained expert such as Mr Radwan Almousa, a skilled consultant ophthalmologist. He speaks to Top Doctor about how ptosis occurs, treatment options and the high standards required for procedures regarding the condition.
Usually, ptosis develops as a result of gradual disinsertion of the muscle responsible for upper lid lifting (the levator muscle) from the eyelid lid platform (the tarsus), which gives the eyelid its contour.
The main reason for levator muscle disinsertion is involutional (age-related). Sometimes, chronic mechanical rubbing, like in the case of patients wearing contact lenses, could also cause ptosis.
If ptosis appears at birth, it is classes as congenital ptosis, and this is usually due to poorly-developed levator muscles rather than disinsertion.
Involutional ptosis (age related) usually develops slowly over years. If the ptosis appears suddenly, it could be due to mechanical reasons, like in the swelling of eyelids due to inflammatory or allergic conditions.
In case of sudden ptosis without lid swelling, this could be related to nerve palsy (the third nerve), which needs to be dealt with urgently.
It usually affects both eyes to a different degree, however the less-affected eye might appear normal due to compensated frontal muscle action that a patient would be using to lift the eyelids.
In case of nerve paralysis, it is usually one side.
In early stages, ptosis might be asymptomatic and as the condition worsen, the patient would start to notice the abnormal eyelid shape with droopy eyelid and hollowness between the brow and the upper lid margin. As the case worsens, the visual fields start to be constricted superiorly (in or to a more superior position or direction), especially when reading, as the upper eyelid covers the visual axis.
The non-surgical treatments for ptosis are usually temporary like eyelid crutches that are attached to a spectacle. Also, transparent tapes could be used to tape the eyelid open.
Surgical treatment for ptosis is highly successful and it involves reinserting the levator muscle back to the tarsus, and that could be achieved from the skin, especially when the ptosis surgery is combined with blepharoplasty to remove excess redundant skin from the upper lid.
Also, the surgery could be done from the inside of the eyelid to avoid skin scar.
Congenital ptosis is treated by connecting the upper-lid platform to the frontal muscle or shortening the levator muscle.
Surgical treatment is the ultimate treatment for ptosis. Both anterior approach (from the skin) or posterior approach are equally effective in treatment for involutional age-related ptosis.
When searching for a ptosis surgical treatment, it needs to be done by an eye surgeon that has had clinical training in oculoplastics through a proper fellowship. This is because safe and successful surgery needs very good knowledge in eyelid anatomy, which is a very unique area.
Looking for a consultation with an expert regarding ptosis or other eye conditions? Book with Mr Almousa’s by calling or emailing at info@optimalvision.co.uk
*Photos are of Mr Almousa’s patients
Dr Mani has performed more than 20,000 ophthalmic procedures, including LASIK, LASEK, PRK, Femto Cataract, RLE, Lens ICL and Phakic IOL Surgery
I had a great experience performing my laser eye surgery at Optimal Vision Clinic. All the staffs are very helpful, co-operative and supportive throughout the treatment process. On the first call, they explained the entire procedure in details and gave necessary instructions at every stage. My eye surgeon made me feel comfortable and relaxed before and during the procedure. Aftercare was done properly with a thorough check-up of my eyes. I would like to recommend this clinic to everyone!
Very happy and impressed with the highly professional care and service I’ve received at the Optimal Vision clinic. Dr Mani is so professional, and he explained everything about Laser surgery and answered all my questions. The surgery was quick and almost completely painless. My eyes have healed perfectly and quickly. I would highly recommend this clinic.
My husband had been experiencing discomfort in his left eye since July and was seen by various doctors/consultants even at the Queen Mary’s hospital but no abnormalities were found.
This week Dr. Mani discovered the fault which happened to be Retina detachment with three tears.
Dr. Mani’s preciseness and his perfectionist attitude to attention to details, detected the source of the main issue and saved my husband’s eye. We feel utterly grateful and can not recommend him enough for his excellence.
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