Ptosis is when the lid margin itself is low which leads to an obstruction in field of vision. This can occur in children and in adults. In adults, this often occurs because the muscle stretches or loosens from its attachment on the tarsal plate. Children that are born with ptosis (congenital ptosis) often have a poorly functioning muscle. If you have ptosis, it is common to have compensatory use of the forehead and brow muscles in an attempt to elevate the eyelid to see better. Symptoms are often worse at the end of the day and when tired.
There are two muscles in the eyelid that control lid height – the levator muscle and Mueller’s muscle. Surgery involving the levator muscle is performed by making a lid crease incision on the outside of the eyelid whereas ptosis correction by repair of Mueller’s muscle is performed internally thereby avoiding a skin incision. Correction of ptosis can be a dramatic improvement in vision and appearance in allowing the person to appear more alert and awake.
There are multiple approaches to ptosis repair and the approach taken is dependent on the muscle that is being repaired and how well the muscle moves. Dr. Parbhu is fellowship trained through the American Society of Ophthalmic Plastic and Reconstructive Surgery so she has an added level of expertise to treat complex cases of ptosis or droopy eyelids. This specialized training allows her to assess the eyelids as well as look at the periocular area to determine if the patient also needs extra skin removed (upper eyelid blepharoplasty) or a brow repair to be done which can also contribute to the heaviness of the upper eyelid area. Some patients may also benefit from a lower eyelid blepharoplasty at the time of ptosis repair as well.
Because she is an ophthalmologist who is fellowship trained in oculoplastic surgery, she can also take into consideration any eye issues such as dry eye which is important to treat prior to eye surgery. She has a special interest in dry eye and believes it is important to treat this before proceeding with eyelid surgery as this condition can worsen when the eyes are opened as a result of the surgery. It is important to see an eyelid specialist when considering surgery around the eyes.
Dr. Parbhu takes an individualized approach to each patient to assess their needs. She develops a customized surgical plan to help you see better and look better.