What is Ptosis?

Ptosis, also known as blepharoptosis or droopy eyelid, is a condition in which the upper eyelid droops or falls lower than normal. It can occur in one or both eyelids and it can affect people of all ages. In some cases, ptosis may be present at birth, while in other cases it may develop later in life due to aging, muscle weakness, or other underlying medical conditions.

Ptosis can be mild, moderate, or severe, depending on the degree to which the eyelid droops. Mild ptosis may not cause any functional problems, but moderate to severe ptosis can cause vision problems, as the drooping eyelid may obstruct the field of vision.

To avoid seeing double, the brain may ignore the image from the eye that has the drooping eyelid and this prevents that eye from developing properly, leading to Amblyopia. You may have heard this condition referred to as lazy eye because of the reduced vision in one eye, but here at Speckles we prefer to call it the “curious eye”. To learn more about Ptosis, check out this blog post.

How is Ptosis corrected?

Ptosis surgery, also known as blepharoplasty, is the most common treatment for correcting ptosis in children. The goal of the surgery is to repair or adjust the muscles and tendons that are responsible for lifting the eyelid. The procedure is usually performed under general anesthesia, and it typically takes about one to two hours.

There are several different techniques that can be used to correct ptosis in children, and the appropriate technique will depend on the specific cause of the ptosis and the age of the child. Some of the most common techniques include:

• Frontalis sling surgery: This technique involves creating a sling or harness using a piece of material (such as a rubber band or synthetic mesh) to hold the eyelid in its proper position. The material is attached to the frontalis muscle (a muscle in the forehead) and to the eyelid, allowing the frontalis muscle to lift the eyelid.

• Muller muscle-conjunctival resection: This technique involves removing a small portion of the Muller muscle (a muscle that helps lift the eyelid) and the conjunctiva (the inner lining of the eyelid). This procedure can be used to correct mild to moderate ptosis.

• Levator resection: This technique involves removing a small portion of the levator muscle (a muscle that helps lift the eyelid) to correct moderate to severe ptosis.

It is important to note that ptosis surgery can be a complex procedure, and it is not always successful in correcting the ptosis. In some cases, additional surgery may be needed to achieve the desired result. It is important to discuss the potential risks and benefits of the surgery with a qualified surgeon before making a decision.

How to prepare your child for surgery.

The best way to alleviate fears of surgery for kids and parents is through information. It is a good idea to give your child a general idea of what they will experience and why it is important, however, the delivery of this information is important. 

We recommend that you start by explaining to your child what Ptosis is and how the surgery will give them a better chance to use both of their eyes equally so they can see the world better. You can use calming words to explain that the doctor will put them to sleep with medicine so they will not feel or remember what happens during the surgery. Ask your surgeon what precautions to take before and after the anaesthesia, such as not eating or drinking and explain these to your child as well. If your child has fears about waking up during surgery, or not waking up at all, reassure them that these thoughts are completely normal, your surgeon is experienced and that complications from anaesthesia are very rare.

Depending on your child's age, it may not be appropriate to explain what happens during the procedure, as this can lead to anxiety. However, we encourage you to provide the opportunity to your child to ask questions and if this topic arises, stick to using reassuring language like "the doctor will use their special tools to readjust your eyelid so that it sits in a better position to help you see".

It is also important to explain to kids what they may experience after the surgery, which are listed below!

What to expect after surgery.

After ptosis surgery, it is normal to experience some swelling, bruising, and discomfort around the incision site. Your doctor will provide you with specific instructions for caring for the incision and managing any discomfort. It is important to follow these instructions carefully to ensure proper healing. It is easy to become alarmed or anxious when your child is in pain so we encourage you to remember that these side effects are normal. You can expect your child to experience

• Grogginess or nausea from the anaesthesia
• Pain in the eye or eyes that were operated on
• Redness in the eyes
• Pink discharge from the eyes and nose
• Double vision
• Aftercare such as applying ointments or eye drops

You can relieve your child's pain through medicines like Panadol, just remember to always read the label and use only as directed. Other ways to calm and comfort your child include dimming the lights and popping on an audio book, holding a cool washcloth on their closed eye to reduce swelling or simply lying down with them while they fall asleep. Other precautions to take after surgery and explain to your child include washing your child's hands regularly to avoid infection and avoiding rough play, swimming or getting water in the eye for at least 1 week after surgery.

It is important to keep all follow-up appointments with your doctor to ensure that the surgery is healing properly and to address any concerns or problems that may arise. Your doctor may also provide you with specific instructions for protecting your child's eyes from injury and avoiding activities that could strain the muscles around their eyes.

When should you be concerned?

It is normal to have some mild to moderate discomfort after the surgery, but it should gradually improve over the first week or two. If you experience severe pain, or if you notice any unusual symptoms, such as fever, excessive swelling, or redness around the incision site, you should contact your doctor as soon as possible. 

We hope this explainer has helped give you a better insight about ptosis surgery and its simplicity and success rate, whilst hopefully easing any stress. If you have further questions, shoot an email to hello@specklesforkids.com, DM us on social media or speak to your friendly eye care professionals.