“Lazy Eyelid” Repair

By Joseph Walrath, MD | May 2, 2015 | Pediatric, Ptosis

Some children are born with significant droop of one or both of the eyelids, known as “congenital ptosis”.  Adult-onset droop is usually known as “involutional ptosis”, and basically means that a tendon has been stretched that needs to be tightened up.  Congenital ptosis is entirely different: it’s not that the tendon is loose, but rather that the muscle doesn’t work properly.  Repair of congenital ptosis is much more complex than repair of involutional ptosis.

This young boy come to me with no prior history of surgery, and was born with a drooping right upper lid.


His eyelid function was about 50-60% of normal.  In cases with at least 30-40% of normal function, it is generally possible to fix the droop with a procedure known as a “levator resection”.  In his case, the lid surgery was done in about 30 minutes under general anesthesia.  Postoperative 1 month results depicted below:


There was no meaningful postoperative pain associated with this procedure.