Op. Dr. Melih Türe, Ophthalmologist and Founding Partner of Atagöz Eye Diseases Center, emphasized that eyelid drooping in infants and children should not be ignored, stating that “eyelid drooping can lead to permanent amblyopia (lazy eye).”
Dr. Türe explained that the cause of congenital eyelid drooping in infants must be carefully investigated, as it may result from underdeveloped eyelid muscles, a neurological condition, or muscular disorders. He added, “The eyelids are among the most dynamic organs of the body. They are essential for maintaining eye moisture, protecting the eye, cleaning and nourishing the surface of the eye—foundational elements of ocular health. The eyelids reflexively open and close 12–16 times per minute. If we think of the eyelid like a car windshield wiper, it protects the entire surface of the eye, maintains moisture and optimal vision, and cleans the frontmost window of the ocular surface.”
Regarding the causes of congenital eyelid drooping, Dr. Türe said, “We can classify eyelid disorders into those occurring in adults and those in children. In children, the most common condition is congenital ptosis, which usually occurs due to developmental issues in the muscles that control the eyelid. The treatment is definitely surgical, and the key is deciding the appropriate timing for the operation. Successful outcomes require accurate diagnosis of the patient. While the most frequent cause is underdeveloped eyelid muscles, in rare cases, eyelid drooping may be caused by neurological or muscular disorders.”
Emphasizing the lifelong risk of amblyopia if treatment is delayed, Op. Dr. Melih Türe stated, “The fundamental principle of treatment is to prevent the eye from becoming lazy and to eliminate the risk posed by eyelid drooping. In children who develop amblyopia due to eyelid drooping, even if the eyelid is surgically corrected, the amblyopia can become permanent.
An eye that cannot see cannot learn. If families ignore eyelid drooping, we often observe that the child learns later than peers and avoids reading and writing.”
Dr. Türe explained the causes and treatments of amblyopia as follows:
Amblyopia develops for two reasons. The first is visual deprivation amblyopia, which occurs when the pupil or visual axis is blocked, leading to vision loss. The second, more common cause, is when the eyelid droops over the eye surface, potentially causing high astigmatism.
If these risk factors are present, early surgical intervention is medically necessary. In surgery, since the patient’s own eyelid muscles are often weak, we treat it either with a silicone material or, if the patient is older than three to four years, by using tissue taken from the leg in a procedure called frontal suspension surgery, which connects the eyelid to the eyebrow. This method lifts the eyelid. The timing of the surgery, the surgical technique, and post-operative care are critical.
Close follow-up and protective measures are needed to prevent the eye from drying out. If there is no risk of amblyopia, the recommended time for surgery to address cosmetic concerns is usually before the child starts school.
We often see cases in older age groups because families did not take eyelid drooping seriously during infancy and correct it surgically. It is crucial that families understand the risk of amblyopia due to drooping eyelids and that early diagnosis and timely surgery are performed to prevent permanent vision loss.
Unfortunately, once amblyopia develops, there is no effective treatment. When eyelid drooping is noticed, the child should be examined immediately to evaluate whether amblyopia or its risk is present. Family awareness and cooperation during diagnosis and treatment play a vital role in achieving successful outcomes.
Highlighting that congenital eyelid abnormalities can rarely occur, Op. Dr. Melih Türe stated, “Rarely, infants and children may have congenital eyelid shape abnormalities. In addition, familial eyelid syndromes can also appear. The main treatment for all of these conditions is surgical, and we achieve nearly 100% successful results from these operations.”
Emphasizing the importance of eyelid drooping in infants and children, Dr. Türe said, “Eyelid drooping in infants and children is a significant condition and should not be ignored. Once amblyopia (lazy eye) develops, surgery cannot restore the vision that has been lost.”
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