Congenital ptosis (drooping eyelid) is often caused by maldevelopment of the levator superioris muscle.  This condition may affect one or both eyelids.  Congenital ptosis is typically evident shortly after birth.   Your child may exhibit a “chin-up” position that enables improved vision because of the droopy eyelid(s).  Amblyopia (lazy eye) and strabismus (cross eyes) are associated with congenital ptosis in up to 20-30% of all cases.  If you suspect congenital ptosis in your child, please consult your pediatrician or pediatric ophthalmologist as soon as possible.  Early treatment of congenital ptosis can prevent permanent vision loss (amblyopia).  Congenital ptosis can be present in one or both eyelids.  When one eyelid is more droopy or ptotic than the other eyelid, the chance of developing amblyopia is higher.  This is because the brain receives a clearer image from one eye (the normal eyelid) compared to the eye with congenital ptosis.  Blurring of the vision on the ptotic side is typically from anisometropia from astigmatism induced by the heavy upper eyelid.  In more severe cases, the eyelid with congenital ptosis can cause complete occlusion of the visual axis, the so called occlusion amblyopia.  

    There are a variety of methods to treat congenital ptosis.  For children with good to fair function of the levator muscle, a levator resection procedure can be performed.  For poor levator function, a frontalis sling/suspension can be performed.  In this procedure, a sling either  from silicone or fascia lata is used to connect the eyelid to the frontalis muscle (brow elevating muscle). 

Before and after photographs of young patient with congenital ptosis of both upper eyelids.

In the photos shown above, this patient presented with severe drooping of both upper eyelids.  He had moderate levator function.  As you can see from the photographs above on the left, the eyelid is transecting the pupil.  Dr. Korn performed congenital ptosis repair in San Diego using the levator resection technique as shown on the right side.  

    For more before and after congenital ptosis repair cases, please see the photo gallery.