Often times with age, sun exposure, familiar predisposition, or weight fluctuation people are left with excess eyelid skin which results in a heavy upper eyelid appearance giving the patient a “tired look.” The decrease of muscle function of the levator palpebrae muscle over time can result in ptosis of the upper eyelid/involutional ptosis. In rare instances, there is atrophy of the levator palpebrae superioris muscle of the upper eyelid, which results in ptosis of the upper eyelid and visual obstructions. The upper eyelid looses its function, and therefore vision ultimately becomes obstructed.
Case: This patient is a 60-year old male who presented with a chief complaint of unilateral worsening ptosis of the upper eyelid with resulting visual obstruction. After a thorough evaluation and physical examination, it was my opinion that he presented with a dysfunction of the Levator Palpebrae Superioris Muscle, which controls the function of the upper eyelid. My surgical advice was to shorten the levator muscle on the right eyelid and perform a bilateral upper blepharoplasty.
Surgery: Bilateral upper blepharoplasty, right upper eyelid blephroptosis correction with shortening of the levator palpebrae muscle opuroneurosis.