What is Congenital Ptosis?

Congenital Ptosis is the medical term for drooping of the upper eyelids or eyelids, a condition usually from birth.

The ptosis may be mild – in which the lid partially covers the pupil; or severe – in which the lid completely covers the pupil.

Children with significant ptosis may need to tilt their head back into a chin-up position, lift their eyelid with a finger, or raise their eyebrows to see from under their drooping eyelid(s).

While the cause of congenital ptosis is often unclear, the most common reason is the improper development of the levator muscle which may have a familial predisposition. The levator muscle is the major muscle responsible for elevating the upper eyelid.

Children with congenital ptosis may also develop amblyopia (“lazy eye”), due to reduced sensory input from the lids being smaller. Strabismus (eyes that are not properly aligned or straight), refractive errors, astigmatism, or blurred vision are other causes of amblyopia. In addition, drooping of the eyelid may result in an undesired facial appearance.

Congenital ptosis is treated surgically, with the specific operation based on the severity of the ptosis and the strength of the levator muscle. If the ptosis is not severe, and there is no threat of amblyopia, surgery is generally performed when the child is between 3 and 5 years of age (the “pre-school” years). However, when the ptosis interferes with the child’s vision, surgery is performed at an earlier age to allow proper visual development.

Congenital ptosis is most often treated by ophthalmic plastic and reconstructive surgeons who specialize in disease and conditions affecting the eyelids, lacrimal (tear) system, the orbit (bone cavity around the eye), and adjacent facial structures.