This may simply be an aesthetic issue, or may even affect the eyesight because the upper eyelid 'covers' the pupil and the person affected is unable to see out that eye. However, all the patients come to see us because theyve noticed a 'droopy eyelid'. Other palpebral ptsosis aetiologies are mechanical, neurogenic and traumatic. There are many different causes of eyelid ptosis. If the visual axis is not affected, it becomes a type of aesthetic ptosis, and should be corrected whenever the patient or their parents see fit. In these case, if the involvement is significant and the pupil is affected, it is fundamental to see a specialist as soon as possible, to asses the visual function of the eye and prevent the development of amblyopia, commonly known as lazy eye. ![]() The patient is born with a malfunctioning levator muscle, whereby regardless of its states of aponeurosis, it is not capable of performing its function properly. The second most common aetiology is congenital ptosis. It comes about during childhood, even after birth, and it is based on a levator muscle function fault. This structure lengthens and stops having the consistency and tension required to work properly, so the upper eyelid droops. With its derpy frown, glistening flesh and an impossibly human-looking nose reminiscent of the schnoz on Ziggy and Kilroy drawings, the fish was an internet star just waiting to happen. In these cases the levator muscle might be completely healthy and work well, but the ageing processes affect its tendon, known as aponeurosis. ![]() The most common type of ptosis is involutional, or aponeurotic, which mainly occurs in older people due to ageing. ![]() This is the most important muscle involved in eyelid opening, and the eyelid failing to close properly is practically the norm. The aetiology of eyelid ptosis is very varied, fundamentally with diverse effects on the levator muscle of the upper eyelid.
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