Palpebral ptosis is more common than thought, but specialists usually find it difficult to find the origin of this disease, due to its extensive list of causes. Most are taken directly to surgery (blepharoplasty), even when they are not necessary and without prior rehabilitation treatment. Even when surgery is performed, the patient will need physical therapy to decrease inflammation and restore mobility of the eye. In the case of dehiscence of the levator muscle surgery is required but muscle paralysis common motor may pass before for physical therapy and assess its progress. The diagnosis is usually clinical, supported by complementary examinations, That is why the physical therapy will depend on the underlying cause.
What is ptosis?
Also called Blepharoptosis, It characterized by the drooping eyelid below its normal position, either unilateral or bilateral, obstructing the visual field of the person. Children can be congenital, for example, abnormal development of the levator palpebrae, Following this the child may suffer from strabismus, lazy eye and / or blurred vision. Adults can occur from trauma, Hypertension, diabetes, infections, Myasthenia gravis or some neurological dysfunction (Horner syndrome, Stroke, Cerebrovascular disease , etc).
Causes of ptosis palpebral
There are a lot of factors that can cause ptosis and to summarize they shall be classified according to their origin, some of them are:
- myogenic: myopathy common levator, involvement of pulse transmission at the neuromuscular junction.
- Aponeurótica: defect congenital or acquired aponeurosis, disinsertion common levator.
- Mechanics: gravitational defect caused by a scar
- Neurogénica: III cranial nerve palsy, microvascular ischemic disease
- congenitally: anomalous synkinesias, Congenital myasthenic syndromes
- Diabetes mellitus
- Traumatic
- Others
Symptoms of ptosis palpebral
Symptoms may vary from person, sometimes they not present with the same intensity and depend on the source of ptosis.
- Usually it does not generate pain
- Absence of voluntary mobility, it is difficult to raise the lid to open the eye
- Altered sensation in the affected area
- tearing involuntary
- Diplopía (double vision)
- Blurry vision
- Eyeball diverted
- Absence of light reflex
Severe cases or compromised, Most of the time, They refer to surgery to raise the upper eyelid or to repair any structure that has been injured and cause eyelid drooping. In the post-surgical process physiotherapy may act on inflammation and recovery of both the sensitivity and the movement of the muscles involved. However, as there are cases of neurogenic origin ptosis, where there is usually a focal ischemia, which it is very common in patients with hypertension, arteriosclerosis and diabetes mellitus, they have large percentage of recovery through physiotherapy, without subjecting the patient to surgery. Exercise routine usually involves forcing use of the affected eye, which will help regain feeling, force, Eyelid motor skills and other muscles involved. The patient can perform these exercises a few minutes every hour.
Source: fisioterapia-online.com
