Can I Have Laser Eye Surgery if I Have Ptosis?

Thanks to major advancements in Laser Eye Surgery technology and techniques in recent years, this life-changing procedure is now available to more people than ever before. But there are some cases in which Laser Eye Surgery may not be an option. For example, can you have Laser Eye Surgery if you have ptosis? In this article, we’ll tell you everything you need to know.

What is Ptosis?

Ptosis, also called blepharoptosis, is known more commonly by its characteristic drooping of the upper eyelids. In ptosis, the upper eyelid sits in an abnormally low position. Although Ptosis is sometimes referred to as “lazy eye”, this term normally refers to amblyopia. If the condition is severe and left untreated, ptosis can eventually cause amblyopia.

Ptosis can be congenital (present at birth) or acquired later in life. Acquired ptosis is further categorised into five types based on aetiology. Most types of acquired ptosis involve issues with the function of the levator muscle (the muscle responsible for maintaining the position of the upper eyelid):

  • Neurogenic ptosis results from defective interaction of the levator muscle of the upper eyelids. Causes can include third nerve palsy, Horner syndrome, Marcus Gunn jaw-winking syndrome, and multiple sclerosis.
  • Myogenic ptosis is caused by levator muscle myopathy or defect at its neuromuscular junction. This can include myasthenia gravis, ocular myopathy, simple congenital, and blepharophimosis syndrome.
  • Mechanical ptosis occurs when levator function becomes impaired due to the mass effect of an abnormal external structure, such as neoplasm, chalazion, contact lens in the upper fornix, or scarring.
  • Aponeurotic ptosis, also known as Involutional ptosis, is caused by a defective levator aponeurosis (the tissue that connects the levator muscle to the connective tissue in the upper eyelid). This can occur due to ageing, trauma, or post-operative complications.
  • Traumatic ptosis refers to any kind of ptosis caused by trauma to the eyelid. This can include any direct or indirect trauma causing levator transection, cicatrization, eyelid laceration or orbital rooftop fracture with ischemia.

How is Ptosis Treated?

The treatment of ptosis depends on the cause, severity, and function of the levator muscle. For example, mechanical ptosis simply requires the removal of the abnormal structure. However, surgical intervention is usually required where non-surgical options (such as taping the eyelid open and eyelid crutches that attach to glasses) are ineffective.

Surgical interventions can include levator resection, which involves shortening the levator muscle; Frontalis brow suspension, in which the eyelid is tethered with the frontalis muscle; aponeurotic strengthening; and various other procedures designed to elevate the eyelid.

Ptosis and Laser Eye Surgery

Ptosis is not a contraindication for Laser Eye Surgery. So long as your eyes are healthy and you have a suitable prescription, ptosis should not affect your suitability for Laser Eye Surgery; however, recent or sudden onset of ptosis should be assessed by a doctor to determine the cause.

Our rigorous screening process involves a wide range of tests and examinations to help us accurately determine your suitability for Laser Eye Surgery. At this appointment, we will consider your overall health, the health of your eyes, and your prescription to recommend the best course of action for you.

If you’d like to learn more about your suitability for Laser Eye Surgery, get in touch with one of our friendly clinic coordinators today. Alternatively, Book a Consultation at our Harley Street clinic to start your journey to clear glasses- and contacts-free vision. 

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