Answer:

Congenital ptosis is a condition where the upper eyelid droops from birth. It results from abnormal development of the levator palpebrae muscle or the nerve controlling it. This condition can sometimes be associated with other abnormalities, such as congenital heart defects or myasthenia gravis.

Congenital ptosis can affect one or both eyes. The drooping upper eyelid may partially or completely cover the pupil. To see clearly, children often tilt their heads back or raise their eyebrows. If the drooping eyelid obstructs the visual axis, there is a high risk of developing strabismus, amblyopia, or astigmatism.

Dr. Huy uses an ophthalmoscope to examine the internal structures of a boy's eye. *Photo courtesy of Tam Anh General Hospital*.

Currently, no medication or exercises can resolve ptosis; surgery is the only cure. Surgeons perform procedures to shorten the levator palpebrae muscle or suspend the eyelid to the frontal muscle, depending on the severity of the condition.

Early surgery is necessary if ptosis severely obstructs vision and makes it difficult for the child to see, as this prevents amblyopia. If the visual impact is not significant, and beyond aesthetic considerations, doctors may recommend surgery when the child can cooperate well. This typically means the child can lie still, requires only local anesthesia, and has a more stable eyelid structure. However, while awaiting the optimal time for surgery, children require regular monitoring by an ophthalmologist every three to six months to prevent habits like head tilting to see or the development of amblyopia.

It is advisable to take your child to a reputable hospital with an ophthalmology department for an examination. The doctor will assess the severity of the congenital ptosis and advise whether urgent surgery is necessary or if it can be postponed until a more suitable time.

Dr. Nguyen Duc Huy

High-Tech Eye Center

Tam Anh General Hospital, Ho Chi Minh City