Drooping Eyelid = Ptosis
When a drooping eyelid falls low enough to obstruct the upper field of vision, patients may arch their eyebrows with their forehead muscles to compensate. In such “functional ptosis” cases, ptosis correction is important to restore the lost vision and is usually covered by regular health insurance. Less advanced ptosis may not block vision significantly but causes a “tired” or “sleepy” appearance. This aesthetic appearance often creates significant effects on self-image and interpersonal relations. To learn more about how ptosis can be improved, reach out to our ocular practice today. We have locations in Chicago Ridge, IL, Tinley Park, IL, and Munster, IN.
"Very pleasant experience efficient nice staff beautiful medical center for eyes Dr. Tico was informative Reassuring very explanatory thank you This is now my eye dr"- K.V. / Google / Apr 07, 2020
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"I have been with Dr. Ticho for 32 years...I am 32 years old now. He has done multiple surgeries on both my eyes. His staff is always nice and kind. you have to wait 90% of the time at your appointment but I think people should have more patience. Hes performed my cataract surgeries and has always been honest with me. I would recommend people to dr. Ticho without hesitation."- K.P. / Google / Dec 07, 2019
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What Causes Ptosis?
The most common cause of ptosis is age-related skin drooping. However, there are many other reasons why one or both eyelids may droop, including:
Congenital ptosis from malpositioned or maldeveloped levator muscle, which usually lifts the lids
Neurogenic ptosis, a nerve to the levator muscle is defective (third cranial nerve palsy)
Neurogenic ptosis, a defective nerve to the orbicularis muscle (seventh cranial nerve palsy, or Bell’s palsy)
Neurogenic ptosis, a defective nerve to the Muller’s eyelid muscle (Horner syndrome)
Neurogenic ptosis, associated with myasthenia gravis or multiple sclerosis
Mechanical ptosis, which develops as a result of excessive contact lens use, eyelid tumors, or even large chalazia
Involutional ptosis, the most common form of ptosis in which aging causes stretching and weakening of the levator tendon
Ptosis Treatment Options
Unfortunately, ptosis does not respond to eyelid exercises, as muscle weakness is not the root problem. In years past, special glasses might be used to “prop open” the drooping lid, and occasionally, patients would tape the lid up. Fortunately, we now have many safe and effective surgical approaches to ptosis, including:
Levator muscle tightening (external approach): This is the most common approach, shortening and repositioning the main eyelid lifting muscle through an eyelid crease incision.
Muller’s muscle tightening (internal approach): In this technique, appropriate for smaller amounts of ptosis, the lid is “flipped” inside-out, and the Muller’s muscle is tightened from the backside of the eyelid.
Fasanella-Servat procedure: This technique also uses flipped or everted approach to shorten the lid by removing multiple layers rather than just repositioning them.
Frontalis sling approach: When the levator muscle is extremely weak, typically in severe congenital ptosis, the eyelid is directly attached to the forehead (frontalis) muscle.
The eyelid specialists at Ticho Eye Associates offer several treatment options to safely address drooping and puffy eyelids while maintaining a natural-looking appearance.
What is Dermatochalasis?
Dermatochalsis refers to the excess of thin, redundant eyelid skin, which occurs naturally with age. Severe or repeated eyelid swelling can also lead to excess eyelid skin folds. In addition to creating a tired and heavy or “hooded” appearance to the eyelids, dermatochalasis can impair makeup application and occasionally causes enough drooping to impair vision.
In upper blepharoplasty, the excess skin of dermatochalasis is removed through an eyelid crease incision, which effectively hides surgical scarring when the eyes are open. If the sagging upper eyelid skin impairs the superior visual field, blepharoplasty may be considered functionally necessary and may be covered by insurance. Both upper and peripheral vision may be improved by upper blepharoplasty, enhancing awareness of one's surroundings.
Excess orbital fat is occasionally removed, but generally, efforts are made to preserve eyelid volume to avoid a “hollowed out” appearance. By repositioning fat and tightening lax orbicularis eyelid muscle in addition to removing the excess skin, blepharoplasty can produce a more relaxed and youthful appearance.
More complex than upper blepharoplasty, lower blepharoplasty incisions may be performed via the inner surface of the eyelid (transconjunctival approach), just below the lower eyelashes (subciliar approach), or a combination of the two. Lower eyelid fat tends to sink with gravity, accentuating the “dark circles” of the tear trough, and may benefit from repositioning. The eyelid experts at Ticho Eye Associates will perform a thorough evaluation to match each patient’s goals and unique anatomy and the most appropriate surgical approach. Such a personalized process is critical to achieving the natural appearance and functional benefits that create long-term patient satisfaction. To get your eyelid questions answered, please schedule an appointment at one of our practice locations in Chicago Ridge, IL, Tinley Park, IL, and Munster, IN.
MALPOSITIONED EYELIDS: ENTROPION
The eyelids may loosen over time, causing them to “flip” inwards or outwards. Eyelashes which are “turned-in” rub against the ocular surface, causing redness, irritation, tearing, and light sensitivity. Over time, infections, ulcerations, scarring, and permanent damage can result. Most commonly, entropion is an age-related condition, but it may occur as a congenital defect following trauma, lid scarring, or previous eyelid surgery.
MALPOSITIONED EYELIDS: ECTROPION
Ectropion, a “flipped outward” rotation of the eyelid, causes chronic redness, discharge, and ocular surface irritation. Both dryness and tearing are common problems, as the malpositioned eyelid “windshield wiper” fails to flush the eye surface properly.
ENTROPION & ECTROPION: TREATMENT
The eyelid experts at Ticho Eye Associates offer multiple treatments for ectropion and entropion. In mild or temporary situations (from eyelid spasm, for example), artificial tear drops and ointment may be sufficient. Surgical approaches for both ectropion and entropion generally involve tightening associated laxity and correcting the lid rotation. This may be done by flipping the lid in the correct direction using vertical sutures, tightening the outside corner of the eyelid (tarsal strip procedure), or shortening the overall lid length with a wedge procedure. Whatever procedure is used, there is a high rate of success in correcting both the aesthetic and functional status of the eyelids. Call our offices in Chicago Ridge, IL, Tinley Park, IL, and Munster, IN to book an appointment.
RETINOPATHY OF PREMATURITY
Retinopathy of prematurity (ROP) is a disorder found in premature and low birthweight infants born under 32 weeks of gestation. The retina covers the back of the eye’s inner surface, detecting and transmitting light and vision signals to the brain via the optic nerve. Normally, the blood vessels that supply the retina with oxygen and nutrition don’t reach maturity until shortly after full term. Therefore, in premature infants, the retinal blood vessels have some growing to do.
In most premature babies, the vessel toward the retinal edge proceeds without complications. Occasionally, the vessels grow abnormally and can bleed or form scar tissue, which may lead to irreversible vision loss or even blindness. The most famous ROP victim is probably the musician Stevie Wonder.
Benjamin Ticho was a investigator in some of the most important ROP research in the past 25 years, including the STOP-ROP and ETROP studies:
If your child was born premature, please contact Ticho Eye Associates to schedule this crucial eye examination. We have three facilities located in Chicago Ridge, IL, Tinley Park, IL, and Munster, IN.
RETINOPATHY OF PREMATURITY: DETECTION
The only way to detect ROP is to look for it! Babies born under 32 weeks gestation or 1500 grams birthweight should be examined by six weeks post-delivery. Usually, the first ROP examination will be performed in the hospital. However, if your baby is discharged prior to six weeks of age, please make sure to arrange an ROP examination at Ticho Eye Associates promptly. Once vision loss has developed, the best chance to prevent permanent vision loss may be past.
The examination for ROP involves dilating the infant’s pupils and focusing a light through a lens onto the retina. Because the abnormal ROP vessels are growing on the side parts of the eyeball, they must be pushed into view through a process called scleral depression, or an indentation exam.
If your baby was born prematurely, you should schedule an eye exam with one of the expert pediatric specialists at Ticho Eye Associates to check their overall eye health and development. As with many other health conditions, early diagnosis is essential to correcting ROP and protecting your child’s sight.
RETINOPATHY OF PREMATURITY: TREATMENT
If your baby shows only early signs of retinopathy of prematurity, Ticho Eye Associates will schedule a series of appointments every 1-3 weeks to monitor expected retinal development and vision until the danger has passed. However, if the ROP is severe, Dr. Ticho may offer one of the two most common ROP treatment options: laser ablation eye surgery or an intraocular medication injection. While ROP is a scary condition, rest reassured that our team is here to guide you through the process in a careful, compassionate, and thorough manner. Schedule an ROP consultation at Ticho Eye Associates to monitor your infant’s eye health and development.