What is the Most Common Cause of Ptosis?

Ptosis, drooping of the eyelids, has both visual and cosmetic implications. Ptosis also has many causes; for some it is congenital, while it’s an acquired condition for others. What is the most common cause of ptosis?

In adults, acquired ptosis is the most common cause of drooping eyelids. As we grow older, the area around our eyes gives in to age and gravity. The muscles that work to hold up our eyelids weaken over time, and the nerves that control these muscles lose function. When the nerves and muscles are no longer fully activated, our eyelids begin to droop down.

There are several types of acquired ptosis. They all develop over time, but each is categorized by a different root cause.

Myogenic ptosis: The levator muscle, located at the center of the upper eyelid, is responsible for contracting to lift the eyelid up and open. When the levator muscle becomes weak and unable to fully contract, the eyelid cannot open all the way.

Aponeurotic ptosis: Like myogenic ptosis, aponeurotic ptosis is caused by a defective levator muscle. In aponeurotic cases, the levator muscle is still working, but has become stretched out over time. The stretching can be due to the repetitive strain the muscle is put under from blinking, or because of external damage, such as the eyelids being rubbed.

Neurogenic ptosis: Unlike myogenic and aponeurotic ptosis, neurogenic ptosis is caused by a dysfunction of the nerves that control the movement of the eyelid muscles. These nerve problems are tied to several disorders, including third nerve palsy and Horner syndrome.

Mechanical ptosis: When the eyelid is weighed down by excess skin, fat or a tumor around the eye, the levator muscle cannot fully support the extra weight. While the muscle is still functioning, it cannot fully perform its job until the excess weight is removed.

Traumatic ptosis: An injury to the eye can damage the levator muscle, preventing it from lifting the eyelid.

Ready to trade your drooping eyelids for open eyes and clearer vision? Dr. Perman has over 35 years of experience in oculofacial plastic surgery, including the evaluation and treatment of all types of ptosis. Call (301) 571-0000 to discuss your ptosis and create a customized treatment plan.