Unilateral Eyelid Drooping

What is Unilateral Eyelid Ptosis?

If unilateral eyelid ptosis is present, it can occur in two different ways. The tissues on our eyelid, including our eyebrow, the skin and subcutaneous tissue of the eyelid, fat tissues, or the lacrimal gland, may sag asymmetrically. These are usually only aesthetic problems due to natural formation and are referred to as pseudoptosis. However, sometimes they may indicate an underlying disease.

More commonly, unilateral ptosis is present, meaning the level of the lash margin has dropped. As a result, the affected eye appears more closed. The most common underlying cause of this condition is the stretching and loosening of the muscle and components that lift the eyelid.

What Causes Congenital Unilateral Eyelid Ptosis?

Congenital eyelid ptosis occurs unfortunately when the muscle system responsible for lifting the eyelid has not developed properly. This condition, which is rarely bilateral, is not genetically inherited. Sometimes, the movement of the eyelid is synchronized with the movement of the muscles that control the mouth. This condition is known as Marcus-Gunn jaw-winking syndrome.

What Causes Unilateral Eyelid Ptosis in Adults?

In adults, unilateral eyelid ptosis is most commonly due to age-related changes. Frequent eye rubbing, contact lens use, recurrent swelling attacks due to allergies or infections, trauma, previous eye or eyelid diseases that cause eyelid stretching, and past eye surgeries can also contribute to unilateral eyelid ptosis.

Is Unilateral Eyelid Ptosis a Sign of Disease? Is It Dangerous?

Unilateral eyelid ptosis can be quite dangerous and must be evaluated through an examination by an experienced oculoplastic surgeon. Some very serious orbital conditions and neurological causes underlying ptosis may indicate diseases that can lead to blindness or even death.

Orbital tumors can cause unilateral eyelid ptosis. A skilled oculoplastic surgeon can detect this condition during an examination, confirm it by requesting appropriate imaging methods such as CT or MRI, and treat it with orbital surgery. If necessary, a sample obtained during surgery can be sent for pathological examination, and the patient can be referred to oncology for additional treatment.

The most dangerous neurological conditions are those originating from the brain or spinal cord. Brain tumors, vascular anomalies, nerve paralysis, and hemorrhages can cause unilateral eyelid ptosis. These conditions can be identified through an oculoplastic examination, which includes an assessment of eye movements, eyelid functions, pupil reaction, and retina examination.

One of the dangerous causes of unilateral eyelid ptosis is Horner’s Syndrome. The most severe causes of Horner’s Syndrome include a lung Pancoast tumor and carotid artery dissection, which can progress silently in young patients and lead to death. These conditions can be diagnosed by examining the level differences in the upper and lower eyelids, pupil size differences, and the reaction of the affected pupil to light.

Myasthenia Gravis, a neurological disease that is treated with medication and usually does not require surgery, often causes unilateral eyelid ptosis. A thorough oculoplastic or neuro-ophthalmological examination can prevent unnecessary surgery and help diagnose the disease early, avoiding serious health complications.

What Are the Symptoms of Unilateral Eyelid Ptosis?

In unilateral eyelid ptosis, one eye appears more closed than the other. This condition creates eye asymmetry, which is more noticeable in the mirror or photos due to optical illusions. If the ptosis is severe, the affected eye may appear smaller than the other or even give the impression of strabismus.

Unilateral Eyelid Ptosis Treatment in Ankara

The treatment of unilateral eyelid ptosis depends on the underlying cause. If there is an underlying cause, it can be identified during an examination, and treating this cause can also correct the eyelid ptosis. However, in adults, the most common cause of unilateral eyelid ptosis is the stretching of the eyelid’s muscle system, and the only treatment is surgery.

The only treatment for congenital unilateral eyelid ptosis is also surgery. There are different surgical techniques available; the appropriate technique is determined based on the degree of ptosis observed during the examination, the function of the eyelid-lifting muscle, the response to the eye drop test, and other oculoplastic evaluations. Surgery can be performed under local or general anesthesia, depending on the case.

Who Treats Eyelid Ptosis?

Considering the potential underlying diseases, eyelid ptosis is an important condition that must be evaluated by an experienced oculoplastic surgeon. An oculoplastic surgeon who specializes in eyelid surgical techniques and treatments will be highly beneficial for both the surgical process and post-operative eye health.