Does one or both of your child's eyelids droop? A drooping eyelid is called blepharoptosis (or just "ptosis"). While it can be the result of trauma, when it appears in children under the age of one it is usually a congenital condition that can lead to lifelong vision problems if it isn't surgically corrected. This is what you should know.
Drooping eyelids aren't the only sign of ptosis.
If only one eyelid droops, it may be easy to spot the difference between the two eyelids. However, if both eyelids droop fairly evenly, or the drooping is slight, your child may compensate by raising his or her brows to help raise the eyelids. He or she may also adopt a "chin-up" posture that allows him or her a better line of sight. That can make it hard to notice the ptosis at first. If you have the slightest concern, check with your eye doctor to be sure.
If your child has ptosis, your eye doctor will probably order blood work to make sure that there is no underlying medical conditions causing the problem, such as diabetes or an autoimmune disorder. He or she may also run an MRI or other tests to rule out nerve damage or a brain injury.
The long-term results of ptosis are serious.
The most common problem associated with childhood ptosis is amblyopia (lazy eye). Amblyopia is poor vision that isn't correctable through glasses or contacts. It develops when the brain never properly learns to interpret the fuzzy visual signals it receives from the weak or partially obscured eye. With ptosis, this can result from having the light partially blocked from the eye on a regular basis by the drooping eyelid. If left untreated, the vision in the eye will continue to deteriorate over time.
The eye or eyes with a drooping lid also experience a slight but constant pressure which can cause the eye itself to become irregularly shaped. This can develop into a type of refractive error known as astigmatism, which will lead to lifelong problems with blurred vision. The potential for long-term problems makes it especially important to address ptosis in infants and toddlers as soon as the condition is detected.
Surgery and supplemental treatments may both be necessary.
If your child's eye doctor determines that the ptosis is caused due to a weakness in the levator muscle, which is responsible for lifting the eyelid, surgery can be done to tighten and adjust the muscle. Sometimes additional work, called a blepharoplasty, has to be performed to remove excess eyelid skin as well.
If your child has already developed a "lazy eye" by the time diagnosis of ptosis is made, it may be necessary to have your child use eyedrops and a patch to help the weaker eye "catch up" to the stronger eye and force it into a more normal development.
While congenital ptosis isn't a painful condition, it is serious and has long-term implications for your child's visual health. Contact your eye doctor at the first sign that your infant or toddler has problems fully opening one or both eyelids for an evaluation and treatment.