Thank
you for your question.
You submitted your question without a photo.
And you’re describing in the details of your question that you’re concerned about
your left upper eyelid position and the arching of the brow.
And you describe that you are aware that you did not have good vision of your left eye.
And that you had good vision of your right eye.
And 10 years later, the eyelid appears to be drooping further and the eyebrow appears
to be arching more.
And it appears that you are concerned about the way things look.
Well, I can certainly share with you my thoughts based on your description of course in the
absence of more details and a physical examination.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Helping patients with eyelids is a very significant part of my practice particularly for both
cosmetic and reconstructive purposes.
And so I would say that in your description, what comes to mind is a condition called ptosis.
Now ptosis means drooping.
And when it comes to eyelids, we mean eyelid ptosis.
Now in this situation, as you are describing, you had poor vision out of one eye and the
eye was drooping.
It is possible that you had significant, what’s called congenital ptosis which means that
you were born with a drooping eyelid.
And the level of that ptosis may have prevented proper visual development in the left eye
which results in a condition of permanent visual loss called amblyopia.
That being said, it seems that in spite of the diminished vision in the eye, there appears
to be an unconscious drive to keep that eye open.
That is commonly seen and it is part of the basis of why that left eyebrow is arched so
much.
Essentially, there’s this unconscious reflex to try to keep that eye open.
It’s very common and it’s common both in patients who have congenital ptosis as
well as patients or people as they get older and their eyelids can potentially droop more
who have acquired ptosis or involutional ptosis that comes with aging changes.
So I think that, based on that, I think it’s important for you to seek a consultation with
an oculoplastic surgeon.
Oculoplastic surgery, this is what we do, we deal with commonly eyelid ptosis.
And it’s an understanding of the way the muscles that lift the eyelid work.
So for example, if somebody has mild or moderate ptosis and they have good muscle function,
you can shorten the muscle and you can get the eyelid to open and look more symmetric.
Or someone has severe ptosis and poor or no muscle function, then you do something like
a frontalis sling operation where you’re using the same muscle that you’re using
to raise the brow to actually raise the eyelid.
There is a particular sequence of examination and information that’s necessary to determine
what kind of surgical procedure would be optimal for you and that’s why a consultation with
an oculoplastic surgeon makes sense.
So look for an oculoplastic surgeon and meet with this doctor and learn about what your
situation is.
I think it also makes sense to have a proper eye exam with an ophthalmologist just to understand
what’s going on with their eye versus what’s going on with the normal or better seeing
eye.
And of course, the more information, the better it is for the oculoplastic surgeon to have
a strategy to help you and your situation.
So I hope that was helpful, I wish you the best of luck and thank you for your question.