We analyze the disease of the upper eyelid - ptosis. The drooping of the upper eyelid as a result of age-related changes. Makeup algorithm

Omission upper eyelid- a problem that most European women face after 40 years. Why does the crease of the upper eyelid increase and is it possible to remove the overhanging upper eyelid without surgery? Do not envy women with an Asian eye shape, who have an epicanthus, but the fold of the upper eyelid is practically absent and, therefore, the upper eyelid cannot fall. There is no need to envy, but it is possible and necessary to reduce the overhanging upper eyelid. . And better facelift to make the upper eyelids without surgery, in order to restore the natural size and shape of the eyes, and the eyelids - young mobility. Yes, and see, in this case, you will be better.

Why are the upper eyelids drooping?

With time natural crease of the upper eyelid can grow, that is, there will be a drooping of the upper eyelid, if two muscles - the frontal and the muscle that lifts the upper eyelid, have weakened, and the skin of the forehead and eyelids has lost the necessary elasticity.

The frontalis is the largest mimic muscle of the face. It is located under the skin of the entire forehead and its function is to raise the eyebrows up. The frontal muscle (like other facial muscles) is practically not attached to the bones and is closely connected with the skin. When, tensing the muscle, we raise the eyebrows up, the skin of the forehead contracts, forming wrinkles. To avoid wrinkles, women often do not use this muscle. . But, then, over the years, weakening, the frontal muscle slides down under the influence of gravity and pulls the skin attached to it. Eyebrows droop and excess skin creates an overhanging upper eyelid.

Another possible mechanism formation of drooping of the upper eyelid consists in the weakening of the muscle eyeball- muscles that lift the upper eyelid. . It is located in the skin above the upper eyelid. . Maybe because over the years people look up less often or close their eyes more often, this muscle loses strength and, together with the skin, descends, increasing the natural crease of the upper eyelid.

If the upper eyelid has drooped and you are not ready to put up with it, you need to do an upper eyelid lift.

How to slow down the drooping of the upper eyelids or do an upper eyelid lift with exercises.

With the help of exercises, you can strengthen, make more energetic the muscles, due to the weakening of which the upper eyelids have fallen. The folds of the upper eyelids will begin to decrease, the eyes will look large, as in youth, and your field of vision will be restored.

To lift the upper eyelids, you need to master and regularly correctly do two exercises of the Gymnastics for the Face course: an exercise for the frontal muscle and an exercise for the muscle that lifts the upper eyelid. These exercises against overhanging upper eyelids are described in detail below, provided with explanations and illustrations, you can also watch a video of their implementation. If necessary, you can also take a master's lesson via video link via Skype. If the topics proposed for the training do not suit you, apply for a training on a topic that you formulate yourself.

Not everyone is born with perfect skin and correct features. For someone to look at themselves in the mirror with pleasure, it is necessary to make an effort. To eliminate some defects, minor cosmetic adjustments are enough. And other shortcomings require more attention. A drooping or hanging eyelid is medically referred to as ptosis of the upper eyelid. The choice of method of treatment and correction depends on the reasons that provoked its overhang.

Hanging eyelid - what to do with it?

Why the eyelid hangs, types of ptosis

The causes of this fairly common pathology are very diverse. Most of the time it's just a feature. anatomical structure, due to national traits or heredity. But some reasons even translate ptosis into the category of diseases.

Ptosis can be unilateral or bilateral. If the eyelid hangs on one side, this is most likely an acquired pathology. And when the overhanging of the two eyes is symmetrical, then this is a congenital defect or anatomical feature.

To the reasons congenital ptosis relate:

• underdevelopment of the muscles that lift the eyelid, due to an autosomal dominant type of inheritance, that is, if one of the parents has this pathology, then the likelihood of its development in children is very high;
• Gunn's syndrome, manifested in the involuntary lifting of the drooping eyelid when chewing, yawning or opening the mouth, the pathology may be accompanied by amblyopia or strabismus;
• the oculomotor nerve is responsible for the correct position of the eyelid, with its pathology, lowering can also be observed;
• in congenital blepharophimosis, the palpebral fissure is pathologically narrow in the right and left eyes, since the muscles responsible for lifting the upper eyelid are underdeveloped.

Acquired causes of drooping eyelids include:

• neurogenic pathologies, such as paralysis oculomotor nerve;
• myogenic, associated with the state of muscle tissue;
• aponeurotic, often associated with age-related changes or injuries, in which the muscle tendons move away from the plate to which they are attached and stretch this overhanging eyelid;
• to mechanical reasons Ptosis refers to trauma and the formation of tumors and scars, which lead to a shortening of the eyelid.

Depending on the degree of closure of the pupil with the eyelid, there are incomplete, partial or complete omission.

Symptoms and Diagnosis

The main sign of the appearance of ptosis is the visual omission of the skin. But this condition can be accompanied by other symptoms:

• irritation of the mucous membrane of the eye;
• rapid fatigue of the eye muscles;
• children are characterized by the position of the "stargazer" - tilting their heads back;
• double image and strabismus.

Diagnostics is carried out in order to determine the causes of overhang. After all, the method of treating or correcting the deficiency will depend on this. Therefore, in addition to visual, ophthalmological examination and study of anamnesis, CT and MRI of the brain are performed.

How to get rid of the impending century?

To solve the problem with the impending eyelid, there are several ways. May require treatment with conservative or surgical methods. If the pathology is neurogenic in nature, then nerve function can be restored with the help of medications or physiotherapy.

In some cases, surgical intervention is necessary, and sometimes it is possible to correct the situation with different methods and the patient himself can choose the most suitable one for him.

If the eyelid is lowered and inactive, the surgeon stitches it to the frontalis muscle. You can also shorten the muscle that is responsible for lowering the eyelid.

When the defect is associated with age-related atrophy or muscle weakness, surgeons recommend blepharoplasty to patients. Its essence lies in the incision of the skin in a natural fold and the removal of excess fiber and skin.

For those who are not ready to lie down on the operating table, but also do not want to put up with their tired and gloomy expression, we can advise a course of special gymnastics.

Exercises to strengthen the muscles of the upper eyelid

1. Eye movements up and down, left and right, in a circle and diagonally, while the head remains motionless.
2. Frequent blinking: raise your head up, direct your eyes even higher and blink quickly for 30-45 seconds, rest a little and repeat again.
3. Close your eyes tightly and hold the hanging eyelids in this position for 5 seconds, then open, look forward and into the distance. Repeat 5-7 times.
4. Attach your fingers to the temples and pull the skin back a little. Blink for 30 seconds, rest for 15 seconds, and repeat. Do 5-7 repetitions.
5. Lower your eyelids, apply to outer corners upper eyelids index fingers and, pressing lightly on them, try to forcefully open your eyes. After that, move the fingertips to the inside of the upper eyelids and repeat the exercise.
6. Raise your head up, you can even tilt it back slightly, and lower your gaze as low as possible until you see your nose. Hold this position for 5-10 seconds, then relax.
7. Lower the upper eyelids over your eyes, cover them with your palms, without touching, give your eyes the opportunity to rest and relax in this way for a minute.

Even after blepharoplasty, preventive eye exercises will help strengthen and restore atrophied and tired muscles.

Folk remedies for impending eyelids

Homemade recipes help to successfully deal with drooping eyelids. Our ancestors from ancient times from birch leaves, parsley root, chamomile. Lotions from potato juice work well.

Poorly selected cosmetics can sometimes also lead to the appearance of ptosis. Carefully sort out your cosmetic shelf. Try to purchase funds from natural ingredients. do not apply before bedtime, do it 1 hour earlier.

The use of makeup is the easiest and fast way remove the overhanging eyelid. It's about not about the complete elimination of the problem, but about a successful cosmetic correction that does not require a lot of money and time.

After waking up, take an ice cube and wipe your eyelids. Cold treatment removes swelling, smoothes wrinkles and rejuvenates the skin.

Watch your health: follow a diet, do not abuse spices, salt, sweets. Try not to drink a lot of water before bed. And most importantly - smile more often and maintain a cheerful mood, this will make you look much better.

Many Europeans do not even think about how kind nature turned out to be to them, endowing them with the ability to open their eyes wide, opening their eyelashes, their own look. Double eyelid: what is it? This is what in many ways distinguishes the eyes of Europeans from the eyes of Asians. Is there a need for a crease between the eyebrow and the upper eyelid, and if someone thinks that one cannot do without it, then how to do it?

The structure of the upper eyelids of Europeans is such that they have a natural fold, which is explained by the peculiarity of their muscles. This fold is inherent in almost 100% of Europeans, while representatives Mongoloid race it is very rare - about 30% of people. Thus, the second eyelid is even, due to which it looks hanging over the ciliary arch. Because of this, it seems that the eyes are tearful, there is some swelling above them, which happens, for example, with.

One of the signs of the Mongoloid race is the narrowed incision of the eyes, and many nationalities belong to it - the Japanese, Koreans, Chinese, Kirghiz, Tatars, Eskimos and many more oriental and northern peoples. They also have the so-called single eyelid- which does not have this fold.

Often their representatives have epicanthus - a fold on the skin of the eyelids, which is clearly visible in inside corners“mirrors of the soul”, and which is an innate phenomenon. Scientists have not yet been able to determine exact reasons the fact that Asians do not have a double eyelid, but Europeans do. The most common theory today is that such a structure of the muscles of the eyelids was given to them by nature to protect them from winds, colds, and sands.

Eastern dream

Asian women are considered very beautiful girls, and this is quite fair, well deserved.

Double eyelid allows you to make the look more expressive

Nevertheless, they themselves often want to be like European women, including considering that a European eye shape, a double eyelid is almost the standard of beauty that they strive for.

Currently, among Eastern women, the idea of ​​\u200b\u200bgetting a double eyelid is very common. by artificial means. This has nothing to do with it, since it cannot be violated for this reason anyway. For some of them, this is another fashion trend, while some really believe that, having received the treasured fold between the eyebrow and the upper eyelid, they are significantly better side change their appearance.

This makes sense, because thanks to the double century:

• eyes become more round shape, due to which they expand, seem wide open;
• wide open eyes give the face youthfulness, a touch of naivety and even innocence;
• it is believed that double eyelids make the eyes look "fresh", while the overhanging eyelid "weights" the gaze, making it tired, as if tearful.

not many asian girls frankly admit that they want to be like Europeans. Most of them explain their desire to have a double eyelid by the fact that with it their face becomes sweeter, softer, more expressive.

How to make a double eyelid?

With the same desire that European women want to get rid of facial wrinkles, Asian women want to have a crease between the eyebrow and upper eyelid. To do this, they resort to the most different methods ranging from cosmetics to surgery.

The crease between the eyebrow and the upper eyelid makes the eyes look rounder.

Justified by this all the same Eastern dream. We often see beautiful representatives of the Mongoloid race on the covers of magazines, TV screens, and do not even realize that nature did not give many of them a double eyelid. But none of them will pose for a photo or video camera until a crease appears between her eyebrow and upper eyelid, allowing her eyes to become rounder and wide open.

Do not lag behind them ordinary girls who are not divas of show business or catwalk. Many of them are sure that, having a double eyelid, they will not only look more attractive, but also inspire more confidence in others. Moreover, some girls believe that even when looking for a job, it will come in handy - employers are more supportive of its owners.

In what ways do they manage to achieve the appearance of the desired fold? None of them will help in this case to get the desired effect.

Non-surgical methods

In order not to expose themselves, many Asian beauties choose less drastic methods to improve their appearance.

Today the most popular of them are:

1. Special stickers.

Currently, they are in great demand, so it is not a problem to purchase them. Adhesive-based strips are applied to the part of the eyelid where the crease should be, and then the skin is pulled up so that it forms. But the effect of such stickers does not last long - literally until the first wash. In addition, the strip may be visible to others. To avoid this, you can mask it using eye shadow.

1. Special glue.

It's over reliable remedy– fast drying and lasts for several days. Using a thin brush, the agent is evenly applied to the line where the fold should be, dividing the eyelid into two parts. Then, using a special brush with two teeth, the skin is pulled back and fixed in this position. Glue can also be purchased today without any difficulty, but you only need to use special composition designed for these purposes. It does not cause allergies, redness of the skin of the eyelids, it is absolutely safe for it, being made from biological components.

Regardless of which remedy is chosen, it must be applied to clean skin- thoroughly washed, including from make-up.

Surgical methods

There are three main operational method used to form a double eyelid.

No cut

Double eyelid - a fold that allows the eye to open

The operation is performed under local anesthesia with sedation, and it lasts only half an hour. rehabilitation period is 3-4 days, while the patient usually does not need to be in the hospital. The stitches are removed after 2 days. By means of a surgical thread, the skin is fixed to the muscle of the eyelid. This occurs through microscopic holes that are not incisions.

With the help of this thread, a fold is formed between the eyebrow and the upper eyelid. The disadvantage of this method is that over time, the threads loosen, which can cause the eyelid to return to its natural position. But in modern plastic surgery specialists try to select the methods of carrying out the operation in such a way that the effect lasts as long as possible.

Partial cut

To make the so-called second eyelid in a person, with this method of correction, medium-sized incisions are made through which part of the muscle and skin tissues is removed, due to which a wrinkle is formed. Before manipulation, the doctor must determine where it will pass, what height and shape it will have. The advantages of this technique is that the incisions are made small, due to which there are practically no seams, puffiness. The latter may appear in the first 1-2 weeks after the procedure, but after this time they recede. The operation takes approximately half an hour local anesthesia. The patient does not need to stay in the hospital after the manipulation, and the stitches are removed after 4-5 days. The main advantage of the method is that in most cases the double eyelid does not disappear with time.

Full cut

it universal way correction, due to which part of the muscle, fat, skin tissues is removed, due to which the eyes become more expressive. The disadvantage of the method is the risk of unwanted seams, which can be noticeable. But the effect, as a rule, remains for life. The duration of the operation is half an hour, it is performed under local anesthesia. The stitches are removed about a week after surgical intervention. After the operation, there may be swelling for some time (approximately 1-2 weeks). Hospitalization after the manipulation is not required.

Should I change my appearance?

Representatives of all nationalities are beautiful in their own way, because each of them has its own “zest” in appearance. If a person does not have a double eyelid, this does not mean at all that he does not have external attractiveness, and this phenomenon does not cause either. But this is a personal matter for everyone - to correct his own appearance with non-surgical and surgical techniques or not.

(ptosis) - an abnormal position of the upper eyelid, resulting in partial or complete closure palpebral fissure. Ptosis is manifested by the low position of the upper eyelid, irritation and increased fatigue eyes, the need to tilt the head back for better vision, the development of diplopia and strabismus. Diagnosis of drooping of the upper eyelid includes measuring the height of the position of the eyelid, checking the symmetry and completeness of the movements of the eyelids of both eyes. Treatment for droopy upper eyelids surgically using a resection operation or creating a duplication of the levator, etc.

General information

Normally, the iris is closed by the edge of the upper eyelid by about 1.5 mm. Ptosis (blepharoptosis) is said to occur if the eyelid falls below top edge of the iris by 2 or more millimeters or is below the eyelid of the other eye when comparing them. Upper eyelid droop can be either congenital or lifelong, so blepharoptosis is quite common among children and adults.

The drooping of the upper eyelid is not only cosmetic defect, but also prevents normal development and the functioning of the visual analyzer, causing mechanical obstruction of vision. Correction of the drooping of the upper eyelid is done by plastic surgery and ophthalmology.

Classification

According to the time of development, congenital and acquired blepharoptosis are distinguished. Depending on the degree of severity, the drooping of the upper eyelid can be partial (the edge of the eyelid covers the upper third of the pupil), incomplete (the edge of the eyelid is lowered to half the pupil) and complete (the upper eyelid covers the entire pupil). Ptosis can be unilateral (69%) or bilateral (31%).

Depending on the etiology of the drooping of the upper eyelid, the following types of ptosis are distinguished: aponeurotic, neurogenic, myogenic, mechanical ptosis and pseudoptosis (false).

The reasons

The lifting of the eyelid is carried out due to the functioning of a special muscle that lifts the upper eyelid (levator), which is innervated by the oculomotor nerve. Therefore, the main causes of the drooping of the upper eyelid can be associated either with an anomaly of the muscle that lifts the eyelid, or with the pathology of the oculomotor nerve.

Congenital drooping of the upper eyelid may be based on underdevelopment or complete absence levator muscles; in rare cases- aplasia of the nuclei or pathways of the oculomotor nerve. Congenital blepharoptosis often runs in families, but can also be caused by pathological course pregnancy and childbirth. Congenital drooping of the upper eyelid in most cases is combined with another pathology of the organ of vision: anisometropia, strabismus, amblyopia, etc.

Aponeurotic blepharoptosis most often develops against the background of involutional changes associated with natural process body aging. Sometimes the cause of the drooping of the upper eyelid is trauma to the levator aponeurosis or its damage during ophthalmic operations.

Neurogenic ptosis of the upper eyelid is a consequence of diseases nervous system: stroke, multiple sclerosis, paresis of the oculomotor nerve, meningitis, tumors and abscesses of the brain, etc. Lowering of the upper eyelid of a neurogenic nature is observed in Horner's syndrome, characterized by paralysis of the cervical sympathetic nerve, retraction of the eyeball (enophthalmos) and constriction of the pupil (miosis). The causes of myogenic blepharoptosis can be myasthenia gravis, muscular dystrophy, congenital myopathy , blepharophimosis .

Mechanical drooping of the upper eyelid may be due to retrobulbar hematoma, eyelid tumors, orbital damage, eyelid deformity as a result of ruptures, injury by foreign bodies of the eye, scarring. Pseudoptosis (false, apparent drooping of the upper eyelid) occurs with excess skin on the upper eyelid (blepharochalasis), strabismus, hypotension of the eyeball.

Symptoms

Blepharoptosis is manifested by unilateral or bilateral drooping of the upper eyelid varying degrees severity: from partial covering to complete closure of the palpebral fissure. Patients with droopy upper eyelids are forced to tense the frontalis muscle, raise their eyebrows, or tilt their head back in order to better see with the affected eye (stargazer posture). The drooping of the upper eyelid makes it difficult to perform blinking movements, which, in turn, is accompanied by increased fatigue, irritation and infection of the eyes.

Congenital blepharoptosis is often combined with strabismus, epicanthus, paresis of the superior rectus muscle. The constant covering of the eyeball with the eyelid eventually leads to the development of amblyopia. With acquired drooping of the upper eyelid, diplopia, exophthalmos or enophthalmos, a violation of the sensitivity of the cornea, is often noted.

Due to the variety of mechanisms leading to the drooping of the upper eyelid, differential diagnosis and correction of ptosis require joint management of the patient by an ophthalmologist, a neurologist, plastic surgeon.

Diagnostics

Primary diagnosis of drooping of the upper eyelid is carried out during visual inspection. During a physical examination, the height of the position of the eyelid, the width of the palpebral fissure, the symmetry of the location of the eyelids of both eyes, the mobility of the eyeballs and eyebrows, the strength of the levator muscle, the position of the head, and other functional indicators are assessed.

In case of mechanical ptosis, in order to exclude damage to bone structures in the levator region, a survey radiography of the orbit is indicated. If the neurogenic nature of the drooping of the upper eyelid is suspected, a CT scan (MRI) of the brain is performed, a consultation of a neurologist and a neurosurgeon is carried out.

Treatment

First of all, the treatment of ptosis of the upper eyelid is aimed at eliminating the functional pathology and only then - at correcting the cosmetic defect.

In the case of the neurogenic nature of the drooping of the upper eyelid, the underlying pathology is treated; in addition, local physiotherapy is prescribed - galvanization, UHF, paraffin therapy.

With congenital drooping of the upper eyelid, as well as the lack of effectiveness from conservative therapy acquired ptosis within 6-9 months, resort to the methods of surgical ophthalmology. The timing of correction of congenital blepharoptosis is set differentially: partial drooping of the upper eyelid is operated on at 13-16 years; full ptosis, in view of the likelihood of developing amblyopia, it is advisable to eliminate in preschool childhood.

Operations for the drooping of the upper eyelid (ptosis correction) are aimed either at shortening the muscle that lifts the upper eyelid (congenital ptosis) or at shortening the levator aponeurosis (acquired ptosis).

With congenital ptosis, the levator is isolated, the muscle is plicated (shortened) by excision or by creating a duplication. In case of severe blepharoptosis, the levator lid muscle is sutured to the frontalis muscle.

The standard operation for acquired blepharoptosis is to remove a thin strip of skin from the upper eyelid, resect the aponeurosis, and fix its lower edge to the cartilage of the upper eyelid. In plastic surgery, drooping upper eyelid correction can be combined with upper blepharoplasty.

Forecast

Aesthetic and functional result of blepharoptosis correction with correctly chosen surgical tactics usually persists for life. When lowering the upper eyelid due to ophthalmoplegia, treatment can achieve only a partial effect. Surgical treatment of myogenic ptosis caused by myasthenia gravis is ineffective.

Left untreated, drooping upper eyelids can eventually lead to amblyopia and vision loss.

Have you ever observed the lack of symmetry in the location of the eyelids of friends or yourself? If one eyelid is lowered too much, or both, this may indicate the presence of the following disease.

Ptosis (from the Greek word - fall) of the upper eyelid means its omission. Normal at healthy person the upper eyelid protrudes approximately 1.5 mm onto the iris.

With ptosis, the upper eyelid is lowered by more than 2 mm. If the ptosis is unilateral, then the difference between the eyes and eyelids is very noticeable.

Ptosis can occur in anyone, regardless of gender or age.

Types of disease

Of the varieties of ptosis, there are:

• unilateral (appears in one eye) and bilateral (in both eyes);
• full (the upper eyelid completely covers the eye) or incomplete (closes only partially);
• congenital and acquired (from the cause of occurrence).

By how much the eyelid is lowered, determine the severity of ptosis:

• 1 degree is determined when the upper eyelid covers the pupil from above by 1/3,
• Grade 2 - when the upper eyelid is lowered to the pupil by 2/3,
• Grade 3 - when the upper eyelid almost completely hides the pupil.

The degree of visual impairment depends on the severity of ptosis: from a slight decrease in vision to its complete loss.

What can be confused?

For ptosis, you can mistakenly take such pathologies of the organs of vision:

• dermatochalasis, due to which excess skin of the upper eyelids is the cause of pseudoptosis or ordinary ptosis;

• ipsilateral hypotrophy, which is expressed in the omission of the upper eyelid after the eyeball. If a person fixes his gaze with a hypotrophic eye, while covering healthy eye, pseudoptosis will disappear;

• eyelids are poorly supported by the eyeball due to a decrease in the volume of the contents of the orbit, which is typical for patients with a false eye, microphthalmos, phthisis of the eyeball and enophthalmos;

• contralateral eyelid retraction, which can be determined by comparing the levels of the upper eyelids. It should be borne in mind that covering the cornea with the upper eyelid by two millimeters is the norm;

• ptosis of the eyebrow, caused by an abundance of skin in the superciliary region, which can occur with paralysis of the nerve of the face. You can determine this pathology by raising an eyebrow with your fingers.

Causes of the disease

Let us analyze in detail for what reasons ptosis occurs.

Congenital

Congenital ptosis occurs in children due to underdevelopment or lack of a muscle that should be responsible for lifting the eyelid. Congenital ptosis sometimes occurs along with strabismus.

When the treatment of ptosis is not paid attention to for a long time, the child may develop amblyopia (lazy eye syndrome). Congenital ptosis is most often unilateral.

Acquired

Acquired ptosis develops for several reasons and is divided into:

• aponeurotic ptosis, which is associated with the fact that the aponeurosis of the muscle, which should lift the upper eyelid, is weakened or stretched. This type includes senile ptosis, which is one of the processes in natural aging body, ptosis that appeared after eye surgery.
• neurogenic ptosis associated with damage to the nervous system after diseases (stroke, multiple sclerosis etc.) and injuries. Ptosis may occur with paralysis of the sympathetic cervical nerve, since it is they who innervate the muscle that lifts the eyelid. Along with ptosis, pupil constriction (or miosis) and retraction of the eyeball (or enophthalmos) occur. A syndrome that combines these symptoms is called Horner's syndrome.
• with mechanical ptosis causes are mechanical damage century foreign bodies. Athletes who have fairly common eye injuries are at risk.
• false ptosis(apparent ptosis), which appears with excess skin folds on the upper eyelid, as well as hypotension of the eyeball.

Establishing the cause of ptosis is an important task for the doctor, since surgery acquired and congenital ptosis is significantly different.

An interesting fragment from the program "Live healthy" about ptosis of the upper eyelid

Symptoms of the disease

One of the main manifestations of ptosis is a directly drooping upper eyelid.

Allocate the following symptoms ptosis:

• inability to blink and completely close the eye,
• eye irritation due to the fact that there is no way to close them,
• increased eye fatigue for the same reason,
• possible double vision due to decreased vision,
• the action becomes habitual when a person sharply throws his head back or strains his forehead and eyebrow muscles in order to open the eye as much as possible and lift the lowered upper eyelid,
• strabismus and amblyopia may occur if treatment is not started on time.

Diagnosis of the disease

If a drooping eyelid is detected, which is noticeable even to the naked eye, doctors need to determine the cause of the disease in order to prescribe treatment.

The ophthalmologist measures the height of the eyelid, studies the symmetry of the position of the eyes, eye movements, and the strength of the muscle that should lift the eyelid. When diagnosing, be sure to pay attention to possible presence amblyopia and strabismus.

In those patients who have acquired ptosis during their lifetime, the levator lid muscles are quite elastic and resilient, so they can completely close the eye when their gaze is down.

With congenital ptosis, the eye cannot completely close even with the maximum lowering of the gaze, and the upper eyelid makes movements of a very small amplitude. This often helps to diagnose the cause of the disease.

The importance of determining the cause of ptosis is that with congenital and acquired ptosis, different parts of the visual analyzer suffer (with congenital ptosis, directly the muscle that lifts the eyelid, and with acquired ptosis, its aponeurosis). Accordingly, the operation will be carried out on different parts of the eyelid.

Treatment of the disease

Neither congenital nor acquired ptosis resolves on its own over time and always requires surgery. It is better to start treatment as early as possible in order to increase the chances of maintaining vision, because ptosis is not only an aesthetic and cosmetic defect.

The operation is performed by an ophthalmic surgeon under local anesthesia, except for children, sometimes under general anesthesia. The operation takes from half an hour to 2 hours.

Until surgery is scheduled, you can keep the eyelid open throughout the day with a band-aid to prevent children from developing strabismus or amblyopia.

If acquired ptosis appeared due to some disease, then in addition to the ptosis itself, it is necessary to treat the provoking disease at the same time.

For example, with neurogenic ptosis, the underlying disease is treated, UHF procedures, galvanization are prescribed, and only if there is no result, surgical treatment.

The operation to eliminate acquired ptosis is carried out as follows:

• remove a small strip of skin from the upper eyelid,
• then cut the orbital septum,
• cut the aponeurosis of the muscle, which should be responsible for raising the upper eyelid,
• the aponeurosis is shortened by removing part of it and sutured to the cartilage of the eyelid (or tarsal plate) just below,
• the wound is sutured with a cosmetic continuous suture.

During surgery to eliminate congenital ptosis, the surgeon's actions are as follows:

• also remove a thin strip of skin from the eyelid,
• cut the orbital septum
• secrete the muscle itself, which should be responsible for raising the eyelid,
• carry out plication of the muscle, i.e. put a few stitches on it to shorten it,
• the wound is sutured with a cosmetic continuous suture.

When congenital ptosis of the upper eyelid is severe, the levator eyelid muscle is attached to the frontalis muscle, thereby the eyelid will be controlled by tension of the frontal muscles.

When the operation is completed, a bandage is applied to the operated eyelid, which can be removed after 2-4 hours.

There is usually no pain during or after surgery. The sutures are removed 4-6 days after the operation.

Bruising, swelling and other effects of the operation usually disappear after a week. cosmetic effect treatment remains the same for life.

Surgery to treat ptosis can cause the following side effects:

• pain in the eyelids and a decrease in their sensitivity;

• incomplete closure of the eyelids;

• dry eyes;

These symptoms in most cases disappear on their own within a few weeks after surgery and do not require any treatment. Some patients may experience subtle asymmetry of the upper eyelids, inflammation and bleeding postoperative wound. The cost of an operation to treat ptosis in Russian clinics ranges from 15 to 30 thousand rubles.