Drooping Eyelid (Ptosis) in Children

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KEY POINTS

• Ptosis is a drooping eyelid that may sag slightly or cover the center of your child’s eye and block vision. This is something that your child can be born with or may happen as a result of prior eye surgeries, injuries around your child’s eye or a nerve problem. If there are problems with vision or appearance, surgery can be done to tighten the muscles that lift your child’s eyelid or raise the eyebrow.
• If your child’s vision is developing unevenly, your provider may recommend using a patch or special eye drops in the stronger eye to help the weaker eye develop.

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What is a drooping eyelid?

A drooping eyelid may sag slightly or it may cover the center of your child’s eye and block vision. One or both eyelids may droop. Drooping of the upper eyelid is also called ptosis.

What is the cause?

Children may be born with poorly developed muscles that lift the eyelid. This may affect your child’s vision and may even stop vision from developing correctly. Your child’s eyelid may press on the eye and change the shape of the cornea, which is the clear outer layer on the front of the eye. An unevenly shaped cornea can cause blurred or distorted vision.

The muscles that lift the eyelid can be loosened or stretched as a result of eye surgeries or injuries around the eye.

Drooping eyelids may also be caused by a nerve problem, a stroke, or a tumor. If your child’s eyelid suddenly becomes droopy, go to the emergency room or see an eye care provider immediately.

What are the symptoms?

The drooping eyelid is the main symptom of ptosis. Other symptoms your child may have include:

• Tilting the head back or raising eyebrows to lift the eyelid
• The eyelid raises or lowers with jaw movements such as when chewing
• Loss of vision, especially in the upper part of the field of vision
• Headache or eyebrow ache from constantly trying to lift the eyelids

How is it diagnosed?

Your eye care provider will ask about your child’s symptoms and medical history, examine your child, and do a visual field test, which uses spots of light to measure your child’s central vision and how well your child sees things on all sides.

Your provider may ask your child to look up and down to see if your child’s eyelid moves properly when your child moves the eye.

How is it treated?

If drooping eyelids are not causing any vision or neck problems, often nothing has to be done. If there are problems with vision, appearance, or neck problems from tilting the head back, surgery can be done to tighten the muscles that lift the eyelid or raise the eyebrow. As they get older, children may need more than one surgery to fix ptosis.

If your child’s vision is developing unevenly, your provider may recommend using glasses, a patch, or special eye drops in the stronger eye to force the brain to use the weaker eye more.

How can I take care of my child?

Follow the full course of treatment your healthcare provider prescribes. Ask your healthcare provider:

• How and when you will get your child’s test results
• How long it will take to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.