It is another of the ‘collateral damage’ of the passage of time. The solution depends on the specific cause that has caused the appearance of this uncomfortable pathology
With age, you know, things fall apart for one reason or another. It’s a shame but that’s how it is. And one of those things that are coming down -the list is long but better to ignore it this time- are the eyelids, closing our eyes and making our eyes smaller… unless we use aesthetic remedies.
“The drooping of the eyelids occurs physiologically over the years. Therefore, from an age, practically all people will present, to a greater or lesser extent, a drooping of the eyelids superiors, explains Eva Vico, doctor of the Ophthalmology Service of the Sanitas La Moraleja University Hospital.
According to Vico, “they fall for different reasons: for a excess skin due to age or various anomalies that affect the levator palpebrae muscle“. This second assumption can occur “both because it is disinsert from your insertion zone spontaneously as because go losing strengthand both reasons are linked to the passage of time”. In addition, he adds, “there are other neurological or myopathic diseases which are rarer but can also affect this muscle causing a ptosis“.
When the drooping of the eyelids is caused by a excess skin on the upper eyelids, “it’s called dermatoacalasia, and is the most frequent cause of this pathology. This is usually related to loss of tone and sagging of facial tissuessomething that is also a natural consequence of aging”.
exist varying degrees of dermatoachalasia and, in advanced cases, “the eyelid skin comes to rest on the eyelashes, causing the patient to notice heaviness in the eyes, difficulty in the upper visual field and giving the gaze looking sad and tired. In most cases, the eyelid isn’t really lowered, so the levator muscle isn’t affected.”
It is a pathology that “affects both men and women and, although their incidence increases with age, they can appear cases in young people. In this sense, this doctor emphasizes that “there is a important genetic loadso its frequency increases in those with a family history”.
To solve this pathology, there is no other option than to go through the operating room. “In the case of the dermatoachalasiais corrected by a blepharoplasty of the upper eyelids. For it, excess skin is removed through an incision at the level of the upper eyelid fold with the intention that it is hidden and, aesthetically, the scar is not seen. In this way, you will get rejuvenate the look and eliminate symptoms caused by that excess skin.
If the problem is ptosis, where there is actually a lowering of the upper eyelid caused by a levator muscle malfunction“surgical intervention to solve it may vary depending on the findings found in the exploration carried out by a specialist”.
Thus, this specialist relates, “when the levator muscle has a good function and in the ophthalmological examination the phenylephrine test (used to assess muscle functionality) is positive, you can make a conjunctival müllerectomy. Through this technique, we approach the eyelid from its inner face, ande removes a piece of conjunctiva and Müller’s muscle (in charge of also contributing to the palpebral opening)”.
On the other hand, Dr. Vico details that “if the levator muscle has a good function but the phenylephrine test is negative On examination, the intervention is performed on the levator palpebrae muscle through a skin incision at the level of the palpebral fold. It can be necessary reinsert muscle in cases where it has spontaneously dislodged. Or a reinforcement of it may be required by shortening it at its insertion point”.
If, on the contrary, the levator muscle has poor function“the only way to correct it is with substitution techniques to the frontalis muscle. In this way, the patient’s way of opening the eyelid is contracting the frontalis muscle, located in the forehead. To achieve this, in surgery, they spend a few inside reinsranging from the upper eyelid to the frontal region so that, raising the eyebrowthe patient achieves the opening of the eyelid”.
In short, according to Vico, “there are various ways to correct drooping eyelids depending on the cause that causes it. And, although in most cases it is simply related to age, there may be significant underlying diseases of muscular and neurological origin that we must rule out through a rigorous ophthalmological examination at the hands of an oculoplasty specialist”.
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