Ptosis- 5 Tips from an Oculoplastic Surgeon

Pradeep Mettu, MD

This patient underwent right internal (i.e. ‘scarless’) ptosis repair.

1. Watch out for red flags.

   Anisocoria - evaluate for Horner syndrome, third nerve palsy.

   Double vision - evaluate for Myasthenia Gravis, third nerve palsy.

   Variability - evaluate for Myasthenia Gravis.

2. Ptosis repair can be 'scarless'.

   • I almost exclusively perform internal ptosis repair (i. e. no skin incision) which yields natural height and contour (see photo).

3. Prescription eye drops (Upneeq) are a non surgical option for some patients.

4. If a patient mentions difficulty reading a book, phone, or tablet, consider ptosis. Ptosis worsens with down gaze sometimes impairing one’s ability to read.

5. Ptosis repair might be an insurance benefit depending on the plan and the findings from the consultation.

   • Aside from Medicare plans, visual field testing (i.e. superior 64 or similar) with the affected eyelid(s) taped and untaped is required by insurance companies.

   • Read more about insurance and ptosis repair in one of our blog posts.

Questions? Email Pradeep Mettu, MD