Why did the eyelid droop? Double eyelid: what is it and why Asian girls dream about it

Drooping heavy eyelids make the eyes look smaller, and make-up becomes more difficult to do. To create a beautiful, stylish and neat beauty look, you need to know special techniques that allow you to enlarge your eyes and not make your eyelids even more heavy.

Basic rules for eye makeup with an impending eyelid:

rejection of mother-of-pearl shadows and glitter
rejection of heavy wide eyeliner on the upper eyelid
rejection of dark shadows on the upper eyelid and heavy smoky makeup

Photos of celebrity makeup with impending eyelids

Blake Lively

A charming blonde knows how to emphasize her appearance. Blake has heavy eyelids and eyes with downturned outer corners. She should not do makeup with mother-of-pearl shadows on the upper fixed eyelid and with heavy eyeliner.

A good option would be a three-dimensional makeup with highlighting the inner corner of the eyes at the bottom with a slight darkening outer corners along the upper eyelid. So the eye visually becomes larger. A little subtle smoky makeup with matte shadows does not draw attention to swollen eyelids.

Jennifer Lawrence

Jennifer has no pronounced swelling upper eyelids, but there is an anatomy that requires careful handling and applying makeup. So, for example, it was a big mistake to emphasize the eyes with eyeliner and highlight the line lower lashes with ignoring the upper eyelid, which visually seemed to lie on the eye.

The most successful makeup for Lawrence is a delicate smokey eye in matte shades of gray and brown without sharp dark lines.

Emma Stone

Emma is the owner of large almond-shaped eyes with heavy swollen eyelids. She is contraindicated in thick shiny eyeliner or pearly colored shadows. All this makes the eyes even more heavy.

The best option is neat arrows, and shadows are preferred in neutral shades.

Rosamund Pike

The British actress has a rather difficult face to make up due to the special anatomy. The overhanging eyelid is combined with small eyes. They can not be left completely without makeup, or make an expressive smoky eye.

If you focus on the eyeliner along the line of the upper eyelashes, covered with voluminous mascara, the eye immediately opens, it seems larger, and the eyelids no longer look heavy.

Rachel Bilson

big Brown eyes with downturned corners, combined with slightly overhanging eyelids, require skill in makeup. For example, Rachel should not make her eyebrows too thin, further increasing the area of \u200b\u200bthe swollen upper eyelid. It is also contraindicated for her and arrows that extend beyond the edges of the outline of the eye, which emphasize the peculiarity of the eyelid.

It is better to give preference to the correct outline of the eye with a matte liner, and mark the eyelids with discreet shadows without the effect of visual weighting.

Taylor Swift

Taylor doesn't have a problem with upper eyelid puffiness, but because her eyes are small and deep set, her eyelids seem to slide over her eyes, hiding them underneath. Because of this, the singer should not do makeup with very thick black eyeliner and shadows.

The most reasonable solution is a neat three-dimensional make-up that enlarges the eyelid.

Camille Belle

Camilla is very beautiful eyes, but combined with heavy overhanging eyelids. This drawback is especially noticeable if the eyelids are left without color and only the area around the eye is emphasized with a liner.

It's enough to see how the actress's look changes in luxurious smoky makeup with long eyelashes. The impending century as it never happened.

Lee Ann Rimes

Highly narrow eyes and very heavy eyelids - actress Renee Zellweger lived with exactly the same data all her life, until she did plastic surgery and transformed beyond recognition. But the singer Lee Ann Rimes, it seems, is not going to radically change her appearance yet, which, to be honest, is very difficult to correct with makeup.

In order not to aggravate the situation, it is worth abandoning dark shades and mother-of-pearl shadows, as well as heavy thick eyeliner. Peach, beige, pink, purple for shadows in combination with long eyelashes will help to look natural.

Malin Akerman

The actress has small narrow and deep-set eyes, and, if not emphasized on purpose, her face looks disharmonious.

To open your eyes and balance the features, you should use smoky makeup with neat thin eyeliner.

Leelee Sobieski

Almond-shaped grey-blue eyes Lily combined with slightly overhanging eyelids is not a big problem.

Nevertheless, it is better to keep makeup in matte shades of shadows and not get carried away with solid heavy lines of eyeliners.

Michelle Williams

The American independent film star often appears on the red carpet with nude makeup, sometimes emphasizing puffy upper eyelid.

To make the beauty look harmonious, Michelle recommends a beautiful feminine smokey eye in matte shades of gray. With this, they become visually larger, and the upper eyelid is visually “pulled up”.

Eva Mendes

Eva is naturally very beautiful expressive eyes, which are combined with heavy eyelids, and with age this defect has worsened.

To make eye makeup look harmonious, you should move the emphasis on eyeliner along lower eyelid, neatly defined eyebrows and apply a small amount of neutral shadows without shine on the upper eyelid.

Gigi Hadid

Gigi Hadid for her non-model face was not reproached only by the lazy. She has a really atypical appearance for a fashion model, especially a puffy face with heavy hanging eyelids and narrow, wide-set eyes.

To neutralize this natural effect, Gigi does different makeup, either refusing eyeliner in favor of simple shading of matte shadows, or relying on non-trivial graphic lines of the liner on the upper eyelids.

Cate Blanchett

The Australian actress has an interesting appearance, but with age, her narrow eyes with down-turned corners began to hide under the eyelids.

To visually open your eyes, you need a gentle smoky makeup in discreet natural shades, always in combination with lengthening mascara.

Karlie Kloss

One of the most popular American models of our time also has quite pronounced impending eyelids. Unlike many previous celebrities reviewed, Carly has a relatively big eyes, so the problem for a young girl does not yet look critical.

smokey eyes in warm colors for warm green eyes, Carly instantly solves the problem of an impending eyelid that becomes invisible.

The drooping of the upper eyelid is a problem that most European women face after 40 years of age. 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?

Over time, the natural fold 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 The formation of drooping of the upper eyelid consists in weakening the muscle of the eyeball - the muscle that lifts 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, lowers, increasing natural crease 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.

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;

the 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 loss nervous system after illness (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 the surgical treatment of 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,
an 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 close the eye completely when their gaze is down.

At congenital ptosis the eye cannot close completely 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 surgical operation. It is better to start treatment as early as possible in order to increase the chances of maintaining vision, because ptosis is not only aesthetic and cosmetic defect.

The operation is performed by an ophthalmic surgeon 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.

Drooping eyelids is a phenomenon known medically as "ptosis". One of the fundamental factors of its development is the process of age-related changes occurring in the body. It is quite easy to determine this problem visually: when lowering, one open eyelid is larger than the other. Hanging eyelids are not only a cosmetic defect: with ptosis, such disorders as narrowing of the visual fields, strabismus, amblyopia (the state of the "lazy" eye, in which it is practically not involved), are often observed.

The described defect can be eliminated by the method surgical intervention, but it is also possible to lift the eyelids without surgical intervention. Conservative therapy will require significant efforts and a lot of time, but, subject to the systematic implementation of the required procedures, it will certainly bring results.

Lowering of the upper eyelid as a result of age-related changes

With age, a person notices how the condition of his skin changes: it loses elasticity, becomes drier and more susceptible to external factors, on it are formed dark spots. In a special way age change appear on the skin. In particular, there is a downward displacement of the skin of the eyelids, which makes them seem hanging and add a few extra years to their owner.

Why does it happen that the skin of the eyelids above the eyes loses its elasticity, forming a sagging "bag"?

The fact is that muscles and ligaments weaken and stretch with age, although they remain firmly connected to the bones. Feeling all the heaviness, the skin, in the layers of which the processes of metabolism and cell renewal slow down, sags. In the resulting subcutaneous folds begin to accumulate fat cells, because subcutaneous fat, covering the bone base of the eyes, shifts downward over time.

Outwardly described processes appear precisely in the form of "bags" of the upper and lower eyelids.

Please note: ptosis of the upper eyelids may be accompanied by such unpleasant symptoms like lacrimation and edema formation.

If the drooping of the eyelids is not complicated by the addition of an infection, then it is possible to deal with this phenomenon without performing a surgical operation. Special exercises, massage, the use of certain cosmetics help to make different eyelids more symmetrical and prevent visual impairment.

A set of exercises to eliminate the manifestations of ptosis

When the eyelid hangs over the eye, the situation can be corrected with exercises and massage. When starting the procedures, you should be patient: it is quite difficult to strengthen weakened muscles.

The main exercises for those cases when the eyelids fall are performed as follows:

Opening their eyes wide, make them circular motions with maximum amplitude, after which they close their eyes tightly. Eyes do not open for a few seconds.
The head is raised up, looking at the ceiling. In this position, open your mouth slightly and blink quickly. The duration of the exercise is 30 seconds or more.
Eyes are closed, pads are placed on the upper eyelids index fingers so that they are located at an angle of 45 degrees relative to the nose. You need to try, overcoming the pressure of the fingers, to open your eyes as wide as possible. After repeating this complex for 30 seconds, briefly close the eyelids, and then return to the execution again.
The eyes are opened wide, the fingertips are applied to the temples, slightly pulling back the skin. In this position, you need to open and close your eyes at a fast pace for half a minute. When performing the exercise, you need to ensure that the fingers do not move.

Lifting the eyelids with a massage is not difficult, it is enough to consistently and regularly carry out the procedure as follows:
Before starting, wash your hands with soap and examine the area of the eyelids for the absence of abscesses, abscesses, irritations, then wash.
After drying the skin, do a little warm-up: lightly stroke the area around the eyes with the pads of the index fingers, without touching the eyelid. After repeating the manipulation about 5 times, blink for 30 seconds.
After giving the eyes a little rest, go to the main part of the massage: attach the pads of the index fingers to the base of the eyelid and gently draw them along the eyebrow line in one direction. Then the fingers are returned to the starting points and the original rubbing is repeated about 15 times.
Finish the massage, which can restore the skin of the eyelids, with light strokes.

Please note: the massage is carried out by covering the eyelids.

It is allowed to massage problem areas cotton swabs moistened with tetracycline ointment.

It is important to massage drooping eyelids daily.

Cosmetics in the fight against drooping eyelids

Another way to remove hanging eyelids is to use special cosmetics. It’s worth mentioning right away that this method is effective only in combination with doing exercises, massaging the eyelids, maintaining healthy lifestyle life in general.

Cream Welada Pome-Granate. Its active ingredient is oil. pomegranate seeds, the value of which is in the ability to moisturize and restore the skin. The tool is suitable for skin that quickly loses tone. According to the information provided by the manufacturer, the cream promotes skin regeneration. Therefore, it is advisable to use it if you need to eliminate wrinkles on the eyelids.
Clarin's Eye Cream Mask. The tool has a tonic effect, eliminates swelling of the eyelids, provides delicate care for vulnerable skin.
Eyelid strips (MagicStripes, Tony Moly). These funds can be called a "one-time" solution to the problem of the impending century. The bottom line is to apply such a strip on the eyelid area in order to immediately lift them. It is easy to apply makeup on top of these “patches”. They are invisible, do not cause irritation, suitable for daily use.

It is important! When choosing a skin care product for drooping eyelids, you should give preference to those that contain vitamin E. This component has a rejuvenating, tonic and healing properties and effectively moisturizes aging skin.

Non-surgical eyelid lift methods

Much more efficient than others existing methods hardware procedures for tightening the skin of the eyelids are characterized.

Non-surgical lifting allows you to get rid of the defect quickly and as comfortably as possible for the patient.

One of the most popular techniques is laser blepharoplasty. The procedure is carried out using a medical laser beam penetrating the dermis. Its effect enhances microcirculation and increases the amount active ingredients in deep layers. For achievement pronounced effect 3-4 procedures will be required at monthly intervals.

Note! Laser blepharoplasty has a number of contraindications. Among them are the period of pregnancy, oncological and acute infectious diseases, diabetes and epilepsy.

It is possible to lift the eyelids with Botox. Botulinum toxin injections promote long-term relaxation of the muscles and their return to their natural state. After the substance is injected into the target area, the eyelids rise slightly, due to which the eyes visually expand.

Other ways to deal with the defect

Treatment of ptosis of the upper eyelid folk remedies- another possible variant problem solving.

Known ways to deal with drooping eyelids:

Application raw potatoes, grated on a fine grater, as a mask. The potato mass is preliminarily kept in the refrigerator for at least half an hour. Apply to face for 15 minutes. Since this one is safe, it is allowed to apply the mask daily.
Drawing on problem areas compress in the form of a napkin soaked in a small amount olive oil. During the procedure, you need to relax the muscles of the face as much as possible and lie quietly for 20 minutes. The frequency of application of the compress is no more than 2 times a week.
Massaging the drooping eyelids with ice cubes. Cryotherapy activates blood circulation and helps keep the skin toned.
Use of cosmetic clay (blue or green). She is bred warm water to the density of sour cream and lubricate the composition of the eyelids, leaving to dry completely. Then the mass is carefully removed with a napkin and washed off with water.

The crease above the upper eyelid, which appears suddenly and frightens with its unaesthetic appearance, can be eliminated if enough time is given to the problem and the necessary efforts are made. So that efforts not only bring benefits, but also do not harm health, it is worth consulting with a specialist before starting corrective procedures.

(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 a 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 drooping of the upper eyelid can be associated either with an anomaly of the muscle that lifts the eyelid, or with pathology. 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 of the 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 with 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 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, mobility eyeballs and eyebrows, levator muscle strength, head position, and other functional indicators.

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. AT 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. Surgery myogenic ptosis caused by myasthenia gravis is ineffective.

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