Oculoplastic Surgery

Acquired Ptosis

Ptosis is the medical term for drooping of the upper eyelid, a condition that may effect one or both eyes. When the edge of the upper eyelid falls, it may block the upper field of your vision.

Symptoms of ptosis include a decreased ability to keep your eyes open, eye strain and eyebrow fatigue from the increased effort needed to raise your eyelids, and fatigue, especially when reading.

In severe cases, it may be necessary to tilt your head back or lift the eyelid with a finger in order to see our from under the dropping eyelid(s). You may also complain that your eyes have a tired appearance from “droopy eyelids” even though you are well rested.

Causes of Acquired Ptosis

Acquired ptosis is most commonly due to stretching of the levator muscle in the eyelid. The levator muscle is the major muscle responsible for elevating the upper eyelid. Another cause of acquired ptosis is interference with the nerve supply to the muscle. Acquired ptosis may occur as a result of aging, trauma, or muscular or neurological disease.

Treatment of Acquired Ptosis

Acquired ptosis is treated surgically, with the specific operation based on the severity of the ptosis and the strength of the levator muscle. Surgery is designed to reattach the stretched muscle to its normal location. If there is poor strength in the levator muscle, a “sling” may be used to enable the forehead muscled to elevate the eyelid.

Surgery is usually preformed with local anesthesia, which numbs the upper eyelid, and with the patient lightly sedated with oral and/or intravenous medications. Some surgeons prefer to use general anesthesia, in which case the patient will sleep through the operation.


Lid malpositions occur frequently particularly in elder patients. An entropion is a lid malposition in which the lids and lashes turn inward toward the ocular surface rubbing the eye with each blink. An ectropion is a malposition of the lid resulting in lid turning away from the eye. This condition cause the ocular surface to be excessively exposed. Symptoms common to both include tearing, irritation, red eye, and reduce vision. Oculoplastic surgical procedure can correct both problems.

Cosmetic Oculoplastic Surgery

Ophthalmic plastic surgery, or oculoplastics, is a subspecialty of Ophthalmology that deals with disorders of the eyelids, orbits (bones around the eyes), and lacrimal (tear) system.

Plastic surgery of the eyelids and brow can help patients see more clearly as well as look younger and rejuvenated. By removing excess tissue and tightening the skin, cosmetic and functional eyelid surgery and browlifts can not only increase the visual field but also “turn back time” by reducing the appearance of wrinkles, lines and sagging skin that make you look angry or tired.