What is ptosis? All you need to know about the eye condition causing a drooping upper eyelid affecting vision

Earlier this week, Bollywood actor Zeenat Aman revealed how she was dealing with an eye condition called ptosis due to an injury that she suffered many decades ago. In the post on social media, the actress says the injury damaged the muscles around her right eye. She continues, "Over the years, it has caused my eyelid to droop further and further. And a few years ago, it became so acute that it began to obstruct my vision."

Aman narrates that while the treatments available at that time and over the decades were unsuccessful, she was contacted by a leading ophthalmologist in April this year. After being indecisive for some time, she decided to commit to the procedure after undergoing a series of tests. Now, Aman is recovering and has said her vision is much clearer than before. She is one of several celebrities who have spoken about their illnesses in the last year. Some of them include Vikram Bhatt and Samantha Ruth Prabhu, who suffer from fibromyalgia and myositis respectively. By sharing their personal stories, there has been a lot more awareness about them among people.

So, what exactly is ptosis? According to Dr Rajdeep Jain, consultant ophthalmology at Kokilaben Dhirubhai Ambani Hospital in Indore, "Ptosis is known as the drooping of the upper eyelid, and the patient usually complaints of a defect in vision and cosmesis."

With the aim of informing more people about the eye condition, mid-day.com spoke to Jain to understand more about it. He not only dwells on the causes and effects but also on the treatment of the condition. While stressing the need to visit the ophthalmologist as soon as one sees signs and symptoms, he also says treatment is the only option, as a person can't do anything on their own.

What are the causes of ptosis?
Jain: Ptosis is classified into the following types:
1. Congenital
2. Acquired based on the age of presentation: The latter is usually further categorised into five types based on aetiology
3. Neurogenic: It results from defective innervation of the levator muscle of the upper eyelid.
4. Myogenic: Levator muscle myopathy or defect at its neuromuscular junction.
5. Mechanical: Levator function is impaired due to the mass effect of some abnormal external structure
6. Aponeurotic: Also known as Involuntary ptosis, it results from a defective levator aponeurosis due to ageing, trauma, or postoperative complication.
7. Traumatic: Any kind of direct or indirect trauma to the eyelid leading to levator transection, cicatrisation, eyelid laceration or orbital rooftop fracture with ischemia can cause ptosis.

What are the effects of ptosis?
Jain: Ptosis can cause problems when you drive, read, or even walk up and down stairs. If you suspect you have ptosis, it is essential to consult with an eye specialist or ophthalmologist.

What are the signs and symptoms that one may be suffering ptosis?
Jain: Drooping eyelids that can obstruct the field of vision are one of the main symptoms. Fatigue or strain from continually lifting the eyelids to see is another symptom. People suffering from this condition can also experience the uneven appearance of the eyes, with one eyelid drooping more. The condition can be unilateral or bilateral along with cosmetic disfigurement.

Which age group or gender is most susceptible to suffering from ptosis?
Jain: Ptosis can be congenital if present since birth.

What are the treatment options available for ptosis in Mumbai and India?
Jain: Treatment of ptosis depends upon the underlying aetiology, the degree of ptosis, and the function of the levator muscle.
In mechanical ptosis, removal of the abnormal structure, i.e., a chalazion, is all that is needed. However, surgical correction is the mainstay of treatment as well as some nonsurgical options available for specific conditions.
An oculoplastic surgeon should carry out surgical correction of ptosis.

Are there any foods that people can eat to prevent or help cure ptosis?
Jain: Unfortunately, droopy eyelids caused by ptosis cannot be cured with natural treatments, exercises, or other home remedies. The nature of ptosis is what prevents it from being treated naturally.
Because ptosis occurs when something disrupts an eyelid muscle or the way the nerves communicate with that muscle, the problem goes beyond any simple form of home treatment.
Sometimes social media users suggest all kinds of ways to treat ptosis naturally. While they are mostly harmless, they will not improve a drooping eyelid.

Some of the most common solutions include:
Placing cold cucumber slices, tea bags, or other cold compresses over your eyes: A cold compress might affect swollen eyelids or puffy eyes, but it will not affect ptosis.
Eating certain foods, such as grapes or carrots: Healthy, whole foods can contribute to better eye health, but will not improve the neuromuscular cause of ptosis.
Supplements like B12 or lutein: There is currently no scientific evidence proving that supplements can help ptosis.
Eye patches: An eye doctor can prescribe an eye patch for a child with amblyopia, but the patch will not affect eyelid drooping. Wearing an eye patch for long periods outside of its recommended use may negatively impact your vision.
Doing facial exercises: Often called "face yoga," face exercises will not get rid of ptosis. At best, exercises may reduce the amount of eyelid droop briefly, but any effect is short-lived.
Unfortunately, ptosis doesn't respond to things you can do alone. The only proven treatment for ptosis that doesn't go away on its own is surgery.
For this reason, most people with cosmetic ptosis (having little to no effect on vision) choose to live with the condition and adapt as best as they can.