It is an important condition for babies to have drooping one or both eyelids. If more than half of the pupil and the visual axis are closed due to droopy eyelids at these ages when visual development is not completed, vision decreases and amblyopia may occur. If it is noticed late, the treatment of lazy eye can be quite long and difficult.
If there is no other eye or systemic disease in a child with a single eyelid droop since birth, the reason is that the levator muscle that lifts the eyelid is not developed congenitally. When this muscle does not work, the patient looks up to see by raising his eyebrow or chin if it is bilateral.
If the visual axis is closed in the presence of congenital ptosis, surgery can be performed on infants from 3-4 months of age. Since the levator muscle, which is responsible for lifting the eyelid, has not developed, frontal suspension surgery is performed and it is aimed to open and lift the lid with the help of the frontal muscle located on the forehead. Silicone suspension material is used for babies and children under 3 years old for this suspension.
Frontal suspension surgery can be performed on one eye or both eyes simultaneously by an ophthalmologist experienced in oculoplastic surgery. This surgery is performed under general anesthesia. A few skin incisions are made on the eyelid and eyebrows, and these incisions usually heal without scarring. After this suspension surgery performed on the patient, the eyelid may remain open while sleeping. If gel tears are applied to the open area while sleeping, children usually do not damage the cornea. However, in some patients, if the valve is removed insufficiently or excessively, or if the forehead is traumatized, it may be necessary to correct this sling with surgery.
With frontal suspension surgery, the visual axis is opened and the risk of lazy eye is eliminated. There may be some asymmetry though. For children, this surgery is performed for functional gain, not cosmetic, in the presence of asymmetry in advanced ages, it can be corrected again. It is a completely reversible surgery.
Especially in the presence of these complaints in infants and children, even if the eyelid is not too low, the need for glasses and astigmatism should be evaluated and treated with a good eye examination.
