Congenital ptosis is a condition in which one or both upper eyelids droop abnormally from birth.

It affects approximately 1 in every 1,000 children.

In severe cases, it can lead to amblyopia if not treated in time.

Surgery offers good functional and cosmetic results.

What is congenital ptosis?

An eyelid defect that can compromise a child's vision.

Congenital ptosis occurs when the levator muscle of the upper eyelid does not develop properly before birth. This prevents the child from fully opening the affected eye, which can interfere with their field of vision and the development of binocular vision.

In some cases, ptosis may be associated with neuromuscular disorders or congenital syndromes that require a full ophthalmological and neurological assessment.

Signs that may indicate ptosis in babies and children

✅ A drooping eyelid on one or both eyes from birth.

✅ Difficulty seeing, if the eyelid covers the pupil.

✅ Tilting the head back or raising the eyebrows to compensate.

✅ Asymmetry in how wide the eyelids open, which can affect facial appearance.

✅ Problems with visual development (amblyopia).

✅ Associated strabismus in some cases.

If you notice any of these symptoms in your child, it is essential to arrange an eye assessment to determine the severity of the ptosis and whether corrective treatment is needed.

Why does this eyelid condition occur?

🔹 Underdevelopment of the levator muscle of the eyelid: This is the most common cause and is due to a defect in the formation of the muscle during pregnancy.

🔹 Neuromuscular disorders and eyelid syndromes: Certain conditions, such as congenital myasthenia gravis, or syndromes such as congenital blepharophimosis can be associated with ptosis.

🔹 Neurological syndromes: Such as Horner's syndrome or third cranial nerve palsy, which include ptosis among their features.

🔹 Birth injuries: Although less common, damage to the nerves or muscles of the eyelid during birth can cause ptosis.

Early detection is key to avoiding vision problems in the future.

Options to improve eyelid function and appearance

🔹 Monitoring and follow-up: In mild cases, where the ptosis does not significantly affect vision.

🔹 Optical correction and vision therapy: If the ptosis has caused amblyopia, treatment is needed to stimulate the affected eye.

🔹 Ptosis surgery: In moderate or severe ptosis that interferes with vision, surgery is performed to lift the eyelid.

🔹 Frontalis suspension surgery: In severe cases, where the levator muscle is very weak, the frontalis (forehead) muscle is used to help lift the eyelid.

Ptosis surgery in children is a safe and effective procedure when performed by ophthalmologists specialising in eyelids and paediatric ophthalmology.