Your child’s eyes are a wonderful window into their personality, mood, and emotions. In just a single glance, they can communicate joy, unhappiness, curiosity, comfort, pain, and just about everything in between.
But if your child has ptosis — an abnormally droopy upper eyelid that partially obscures their gaze — eye contact and communication are just two things that may suffer.
Although ptosis is often mild enough that it doesn’t interfere with normal vision, moderate-to-severe ptosis can hamper your child’s ability to make eye contact, obstruct their eyesight, restrict their ocular development, and lead to unwanted complications like amblyopia (lazy eye).
If your child has ptosis, here’s what you should know about its causes, complications, and treatment.
Pediatric ptosis is a long-term condition that causes a child’s upper eyelid to sag lower than normal. Also known as blepharoptosis or eyelid drooping, this problem can be present from birth, develop during infancy, or emerge in later childhood.
Mild ptosis is usually easier to diagnose when it only appears in one eyelid, as the affected eye looks noticeably different from the unaffected eye. When mild ptosis affects both eyelids, the condition may be less obvious.
Pediatric ptosis isn’t always mild, however. Moderate-to-severe cases can cause the kind of excessive eyelid drooping that leaves most of the upper iris as well as a significant portion of the pupil perpetually covered.
So what exactly causes pediatric ptosis? The answer to that question largely depends on when the condition first appears.
The vast majority of children with ptosis have the congenital form of the disorder, meaning it was present at birth or emerged sometime during infancy.
Congenital ptosis is almost always the result of some type of problem with the levator muscle, which keeps the eyelid lifted when your child’s eyes are open. Congenital ptosis can also be the result of a nerve problem in the affected eyelid.
A child with congenital ptosis may also be born with other coexisting eye problems, including eye muscle disease, ocular movement issues, or abnormal growths, such as an eyelid tumor.
When ptosis develops between toddlerhood and adolescence, it’s not considered congenital, even if the underlying cause is still determined to be weak muscles or nerve damage.
In some cases, however, later-onset pediatric ptosis is actually a sign of a more serious medical condition. In fact, ptosis is often the first noticeable symptom of juvenile myasthenia gravis (JMG), a rare autoimmune disorder that causes muscles — particularly those around the eyes, throat, mouth, and limbs — to weaken after periods of activity.
Noncongenital pediatric ptosis may also be a symptom of a muscle disease (progressive external ophthalmoplegia), a nerve problem (Horner syndrome), or a local eye issue (eyelid infection or tumor).
If your child has a droopy eyelid, it’s important to have the condition checked by a specialist to determine its cause and level of severity. Here at ABC Children’s Eye Specialists, we almost always recommend blepharoplasty (eyelid surgery) to correct moderate or severe cases of pediatric ptosis.
A mild case of ptosis that doesn’t interfere with your child’s vision may not require immediate treatment, however, particularly if your child is still very young. In such cases, watchful waiting — with regular monitoring and eye exams to ensure the condition isn’t causing vision problems as your child grows and develops — is often the best course of action.
As long as the ptosis isn’t undermining your child’s vision and ocular development, putting a surgical correction off until they’re older can provide better long-term cosmetic results.
If the condition is interfering with your child’s vision, scheduling the surgery as soon as possible is one of the best ways to ensure they won’t develop amblyopia in their affected eye or astigmatism in their unaffected eye.
To learn more about ptosis or schedule an eye exam for your child, call your nearest ABC Children’s Eye Specialists office in Phoenix or Mesa, Arizona, or use the easy online tool to book an appointment with one of our ptosis experts.
