drooping eyelids in babies: causes and treatment

The article was professionally approved by Master, Doctor Doan Ngoc Quynh Tram - Pediatrician - Neonatology Department of Pediatrics - Neonatology - Vinmec Nha Trang International General Hospital

Lower eyelid ptosis in infants and children refers to a condition in which the upper eyelid is lower than normal, only slightly drooping, or completely covering vision, which can occur in one or both eyes. Drooping eyelids in babies that occur at birth or during the first year is called congenital ptosis.

Neonatal ptosis is the most common congenital malformation of the eyelids. According to pediatric neuro-ophthalmologists, all newborns have one (several) facial asymmetry, including the eyelids, possibly due to effects from being in utero. Most of these minor abnormalities will correct themselves within the first few months of life. But if a baby's eyelids droop significantly since birth and don't improve over time, it's considered congenital ptosis.
In congenital pediatric ptosis, upper eyelid wrinkles may appear asymmetrical from birth. Over time, you'll notice your upper eyelid drooping more and more. Children with ptosis often tilt their heads back to try to see, or raise their eyebrows a lot to try to lift their eyelids, while increasing tear production. After many years, the abnormal head position of the affected child can cause deformities of the head and neck.
Eyelid ptosis in children can occur in one or both eyelids, which can partially or even completely block vision of the affected eye. This condition often co-occurs with astigmatism due to the abnormal placement of the eyelids on top of the cornea. If left untreated, drooping eyelids in children can lead to vision loss, especially if the eyelids droop to the point of blocking vision.

The levator muscle helps lift your eyelids. In congenital ptosis, this levator muscle is not developed properly, so it is not strong enough to lift the upper eyelid. Researchers are determining the genetic cause of droopy eyelids in children by studying an extended family of 150 members who have had the condition since birth. But most cases of congenital ptosis have no obvious cause. They argue that this is simply a fluke of nature. However, if both eyelids droop, the cause may be genetic or neurological.
Drooping eyelids can also result from other conditions, including:
Birth trauma (due to the use of forceps) Eye movement disorders Brain and nervous system problems Tumors of the eyelids Eyelid ptosis that occurs later (in older children) or in adulthood can have other causes.
A particularly unusual infantile ptosis is called Marcus Gunn Syndrome. In it, the eyelids only droop slightly, but when the baby chews or sucks on the bottle, the upper eyelid will move up and down or wink. Marcus Gunn syndrome is caused by an abnormal misalignment of nerve cells between the jaw and the eyelids. Fortunately, this condition is usually quite mild and does not require surgery.
Pediatric ptosis is usually a single birth defect in a single person, but can also be a sign of a larger condition, especially if your baby has droopy eyelids in both eyes. Your child may need additional testing to rule out larger problems such as eye movement abnormalities, muscle disease, eyelid tumors, or neurological disorders.

Congenital ptosis usually doesn't go away on its own and doesn't get worse over time. Most cases of ptosis are mild to moderate and do not require treatment, unless the family wants surgery to improve the child's vision and cosmetic appearance. Mild ptosis is usually not noticeable when your child is alert and energetic, only becoming more noticeable when he is tired.
If the ptosis is so severe that it interferes with vision, your child may need emergency surgery to develop normal vision. This procedure should only be done when the child is at least 3 years old. At this point, the eyelids are a bit bigger and easier to do.
In most cases, the surgeon will tighten the levator muscle. But if the muscle is extremely weak, the doctor needs to hang the eyelid just below the eyebrow so that the forehead muscle can perform the eyelid lift. If infantile ptosis also causes amblyopia or astigmatism, an ophthalmologist will treat those conditions to restore normal vision. Children may need surgery to strengthen their eyes, stimulate weak eyes, or wear glasses to correct astigmatism.
Thus, not all cases of drooping eyelids require surgery. The ophthalmologist will evaluate the pediatric patient and determine if surgery is needed, based on:
Patient's age Drooping of one or both eyelids Eyelid height, droop Strength of muscles lifting and closing the eyelids Observe eye movements. Your child will also need regular eye exams to make sure the ptosis has resolved and that no other vision problems are present.
Surgery often restores the shape and function of the eyelids, however the eyelids may not be perfectly symmetrical. In rare cases, total eyelid movement is not successfully corrected. Sometimes, a child may need more than one surgery.
If your child is having problems with drooping eyelids or other effects on vision, you can take your child to Vinmec International General Hospital to be examined by a doctor and have appropriate indications for their current condition. in. Through the examination, the doctor will have the necessary assessments and can combine with many different specialties to give the best treatment for the child.
Currently Vinmec International General Hospital has service packages related to vision such as:
Glaucoma package Ortho-K package.

References: parents.com - medlineplus.gov - rch.org.au