Discern the cause of droopy eyelids before making a treatment decision

NEW YORK — Brow ptosis is one of the most commonly misdiagnosed conditions, but looking at the cause of droopy lids could change that, according to a surgeon speaking here.

“For a lot of patients and most of my referring physicians, droopy eyelids are viewed as and treated by blepharoplasty. And I’d to change that perception,” said Ron W. Pelton, MD, PhD, here at the Ocular Surgery News Symposium on Cataract, Glaucoma and Refractive Surgery.

“When you are considering a brow lift, first look at the differences between the male and female brow, which have specific characteristics,” he said. Dr. Pelton also suggested surgeons look for factors that may or may not allow one to hide a brow lift. That is, observe the patient’s forehead position and appearance and the type of brow hair, and determine whether previous surgery due to trauma has been done.

Dr. Pelton described his rules of thumb when deciding whether a brow lift should be done.

“If your upper incision is going to be within 10 mm of the brow, consider a brow lift. Also, if you have a patient with significant lateral hooding, who has had a past cosmetic blepharoplasty and ‘wants more taken off,’ or who has a paretic brow, consider a brow lift,” he said.

“We all know about brow ptosis, and I promise you, if you look for it you’ll see it. And hopefully when you see it, you’ll correct it,” Dr. Pelton said.