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Childhood eyelid ptosis

What Is It?

What is childhood eyelid ptosis?

Eyelid ptosis is the drooping of the upper eyelid over the eye to varying degrees of severity. When it occurs before the age of eight, it is known as childhood eyelid ptosis.

As the child is in a period of visual development and growth, one of the specific consequences of not being able to open the eye normally can be the onset of amblyopia, or “lazy eye”.

The affected eye does not receive adequate visual stimuli and does not develop to its full potential.

What causes it?

The main causes are:

Strabismus: when the eyes are misaligned and point in different directions, the child’s brain, which has a great ability to adapt, suppresses vision in one eye to counter the abnormality and prevent double vision.

Refractive error: when a child has hyperopia, astigmatism or myopia, the image that reaches the brain lacks sharpness, resulting in the brain selecting the vision of the eye with less refractive error.

Cataracts, ptosis (drooping eyelid), retinal diseases: other diseases that interfere with the proper development of vision in children.

What cause it?

In adults, ptosis is usually acquired due to advanced age, trauma, muscle diseases or neurological disorders. In children, however, ptosis is usually congenital (present at birth) and related to poor eyelid muscle development.

Childhood ptosis is not usually associated with family history or any other disease. It is usually a consequence of damage during the embryonic development of the eyelid’s levator muscle, which, despite being well connected to the eyelid, lacks the strength to elevate it.

Other less common causes exist, such as allergic reactions, muscle diseases (Steinert), neurological disorders (progressive supranuclear palsy, Horner’s syndrome, myasthenia gravis) and local trauma.

In some exceptional cases, in which onset is rapid, within days or weeks, an eye examination and imaging tests are necessary to detect for serious conditions, such as aneurysms or intracranial tumours.

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