Descent of the century

Descent of the century

Eyelid drooping is an abnormal position of the upper eyelid skin that cannot be controlled. If we compare the appearance of two eyes, then the normal eyelid is significantly higher than the patient.

The drooping of the eyelid occurs with equal frequency in childhood and adulthood. The drooping of the eyelid can be congenital and acquired. Congenital drooping of the eyelid develops due to abnormal development, absolute absence or defective fixation of the muscle responsible for opening the eyelid. 

Acquired drooping of the eyelid can occur and become more pronounced throughout life. The reasons for the acquired prolapse of the eyelid are all sorts of diseases, damage to the eyelids, nervous disorders in the muscles of the eyelids that raise it. 

In the normal state, the border of the upper eyelid should reach about one and a half millimeters from the edge of the iris. The drooping of the eyelid is a condition in which the border drops by more than two millimeters. Ptosis of the upper eyelid is divided into:

– the first stage, in which the upper eyelid closes the third part of the pupil;

– the second stage, in which the eyelid covers more than half of the pupil;

– the third stage, in which the upper eyelid covers the entire pupil.

If the stage of drooping of the eyelid is serious, then the closed eye begins to see worse over time and, if untreated, vision is completely lost. With the development of ptosis of the eyelid, squint is often observed. Children try to compensate for the omission by tilting their heads back.

The drooping of the eyelid, as a rule, is not eliminated without outside intervention; to eliminate it, they resort to a surgical operation. Surgical treatment of ptosis of the upper eyelid consists of correcting and artificially tightening the muscles of the upper eyelid. If the muscle is very weak, then the doctor tightens not only the eyelid, but also the eyebrow muscle. Surgical correction of ptosis of the upper eyelid is performed under local anesthesia for adult patients, and under general anesthesia for children. The correction operation lasts a maximum of one hour. After the operation and the rehabilitation period, no scars remain. The positive effect lasts a lifetime. 

The epicanthus is approaching the drooping of the eyelid – the so-called Asian fold, a transverse fold in the inner corner of the eye that covers the glands that produce tear fluid. The epicanthus usually flows into the lower eyelid from the upper eyelid and can be of different sizes. Typically, epicanthus is a bilateral phenomenon. If the epicanthus is large, then this can significantly limit vision. A fold in the corner of the eye is a characteristic feature of the appearance of representatives of the Mongoloids. But the presence of this fold in people who belong to other races is considered a pathology and is a rather rare occurrence. 

The congenital Asian fold in young children can be located in both eyes and be located in both the inner and outer corners of the eye. Quite often, epicanthus in young children is combined with ptosis of the upper eyelid, with the connection of the borders of the eyelids in the corners of the eyes, in some cases squint may occur. In the process of development and growth of a child, the epicanthus can contract, up to complete disappearance.

The acquired Asian fold develops due to scarring of the eyelids, in other words, after injuries.

Epicanthus, like the drooping of the eyelid, is surgically removed. The operation is more cosmetic and aesthetic. Wrinkle removal is performed by cutting and moving two pieces of eyelid skin. If there is a combination of eyelid drooping and epicanthus, then absolutely elimination of the defect is impossible.

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