Best Age for Droopy Eyelid (ptosis) Surgery in Children

So many people come to me and asking that my child has droopiness or ptosis and at what age should I correct that, so many parents think that let the child grow little bit and only then I will correct the ptosis. So I am here to answer this questions, I’m Doctor Priti Udhay, an ocular plastic surgeon from Visage by Dr Priti, Chennai.

Why does this ptosis occur, the drooping of the eyelid occurs because the muscle which lifts the eyelid is either maldeveloped or the nerve supply to the muscle is affected at birth during development, or the muscle and nerve junction is affected, in which case the patient has the dropping of the eyelid. Sometimes it can be because of tumor, or swelling because of which mechanically the eyelid is drooping.

At what age should you correct drooping of the eyelid? Now it all depends of the severity of the drooping, if the drooping of the eyelid is so much that the entire eye is covered of the child, what will the child do, he will either lift his chin and try to see or he will not use that eye at all, he will use only the other normal eye, and that can cause permanent loss of vision in the affected eye because now the child is in the development stage, at this stage the eye vision gets developed. If we do not give it any visual stimulation, that eye will permanently lose its capacity to see. Therefore in these children where the visual axis of center of the black portion of the eye is affected, these children need surgery as soon as possible, so that their vision can be developed well.

However if in some children the drooping is less, they are able to see with their eye, there is no chin elevation, there is no head tilt for them to see, you can wait up to 2 or 3 years of age so that at the time the child is old enough for help us take good measurements and we can give a good correction. We do advise you to do it at 2 or 3 years before they go to school, so that they are not embarrassed by their friends teasing them, because a lot of these children have a physiological embarrassment at school, and to avoid that it is a good idea to get them operated at 2 or 3 years of age, when the surgical results are extremely good.

Now how will you know whether the drooping has affected the vision of the patient, now this you can know only by a good consultation with your eye doctor. So whenever the child has one eye looking small compared to the other eye and get the eye tested, sometimes they may glasses which are not associated with the drooping, it is not because of the drooping, but they can be other eye defects associated with the drooping, and also the doctor will be able to tell you at what age it is right to do the surgery. If vision is affected, do it early, if vision is not affected, do it at 2 or 3 years of age. Thank you.