Ptosis eyelid [หนังตาตก, which is the term in Thai] might be classified by thinking about the age at start, extent, etiology, as well as the staying amount of levator palpebrae superioris feature:
- Aponeurotic ptosis. Senescent slippage of the aponeurosis is amongst the most common reason for mild to moderate ptosis in the elderly. The results of gravity, as well as the loss of tone because of aging, stretch the levator muscular tissue and its aponeurosis. Disinsertion or dehiscence of the aponeurosis might be worsened by chronic swelling, intraocular surgical procedure, trauma, or hard call lens wear. Levator aponeurosis developments are normally amongst the ideal procedures for these situations, given that they remedy the underlying etiology.
- Myogenic ptosis. Dysfunction of the levator muscle restricts the eyelid from rising right into the proper setting. The most typical illness responsible for this is myasthenia gravis, facio-scalpulo-humeral muscle dystrophy, myotonic dystrophy, oculopharyngeal muscle dystrophy, persistent modern external ophthalmoplegia, hereditary myopathies, and mitochondriopathy.
- Neurogenic ptosis. Disorder or damage to the oculomotor or supportive nerve or to the main nerve system might result in ptosis. The third nerve passes from the midbrain with the interpeduncular cistern to the spacious sinus before reaching the orbital peak. Intracranial aneurysm, typically arising from the back connecting artery, and resulting subarachnoid hemorrhage, in addition to meningitis, as well as various other compressive and infiltrative sores in the area, may cause ptosis by damaging the third nerve.
- Mechanical ptosis. This happens when the eyelid is heavy for the muscles to raise it, such as in blepharochalasis, orbital fat prolapses, and eyelid lumps. The ongoing enhanced weight on the eyelid will create stretching of the thin eyelid skin. Elimination of the ptosis-inducing mass, if present, as well as excessive eyelid skin, with/without a feasible adjunctive levator resection, eases the issue.
- Traumatic ptosis. In some circumstances, the levator might be disinserted. In more substantial trauma, the levator ligament might have been transected with scar development as well as second mechanical ptosis. There additionally may be third nerve damage. A customized assessment is needed to develop the appropriate surgical technique. Distressing ptosis might likewise intensify later on in life as more levator aponeurosis slippage happens.
