Doctor's Answers (7)
Treatment of diagnosed upper eyelid ptosis almost always requires surgery. While there are many options, including incisional and non-incisional procedures, the best treatment varies between individuals and would require a thorough assessment.
This includes examining the various structures making up the upper eyelid including the skin, fat and muscle, assessing the marginal reflex distance (MRD1), testing your visual fields and levator function, and determining whether any brow drooping is present.
Surgical procedures would then be aimed at correcting abnormalities based on the assessment. Besides functional improvement, it should also help to give you a brighter appearance and less tired look.
Ptosis treatments are Medisave/Insurance claimable if there is proven functional deficit in your visual field, and would require a specialist opthalmologist assessment aside from the examination mentioned above. Ptosis correction can be performed by a trained plastic surgeon or oculoplastic surgeon, and he/she will help to arrange the necessary tests as well as Medisave/Insurance claims.
Hope this helps!
Consultant Plastic Surgeon
As mentioned by Dr Chui, there are a number of different treatments/procedures available to help a patient with ptosis and the best treatment would vary depending on many factors.
In other words, there is no 1 or 2 best treatments. It might very well be that for a particular patient, the best treatment could be one that is not that commonly used.
Ptosis operations in Singapore are done by plastic surgeons or oculoplastic surgeons (eye doctors with fellowship training in plastic surgery around the eyes), so you can consider making an appointment with one of these specialists to first confirm whether you do indeed have ptosis, and then to discuss on the most appropriate treatment plan.
Ptosis surgery is only claimable under Medisave if the droopy eyelids block your vision significantly-and this needs to be certified by an eye doctor (ophthalmologist).
Ptosis is a condition where the upper lid encroaches upon and even covers the visual axis of the eye. This may be a congenital or acquired condition (related to contact lens use, eye surgery including retina detachment or glaucoma surgery).
Old fashioned treatments included using spectacle crutches, however with new and advanced surgical techniques, this option is definitely not commonly used anymore. So much so that the art of manufacturing eyelid crutches to spectacles is fast dying out!
There are many surgical options to repair ptosis, and all will affect the healing time. This may vary between 5 days to 2 weeks of recovery time depending on whether the incision is made through the skin or behind the eyelid (through the conjunctiva), and whether skin / muscle is resected from the front of the eyelid.
You should obtain a detailed assessment by your eye-lid surgeon who can give you specific details about the approach which is most suitable for you, and hence the specific details about the healing time, cost and post operative care needed.
The good news is that if your ptosis is medically significant (impacts your lifestyle, driving, reading, mobility, or obscures your visual axis and / or demonstrates a reversible field deficit on objective visual field testing, the surgery may be Medisave claimable. This would be best ascertained after an in-depth consultation with your ophthalmic plastic surgeon.
Best of luck!
It would be best to first get an ophthalmologist opinion on the severity of your ptosis. If your ptosis is severe enough to cause visual obstruction (this is assessed by lid measurements and visual field testing), you will be able to claim Medisave for your treatment because your ptosis surgery will be deemed a medically-needed operation.
Only an ophthalmologist will be able to assess this.
Another word of caution is that not all ophthalmologists are good for ptosis repair, nor are all plastic surgeons. My advice would be to choose an ophthalmologist or plastic surgeon who is trained specially in lid surgery. Or better still, have the procedure done under the consultation of an ophthalmologist in conjunction with a plastic surgeon.
Hope that helps!
Dr Claudine Pang
All the previous surgeons have given a very thorough explanation on upper eyelid ptosis as well as the possible treatments, as well as the possibility of Medisave/Insurance claim.
My personal opinion is that you shouldn't worry about the "best" treatment for ptosis, but rather finding the best surgeon to operate on your ptosis. He or she should have a long track record of performing this surgery, with a whole plethora of patient photos to show you.
It is very important that you seek someone who performs this surgery on a regular basis, as the first surgery is often the best shot at achieving the best result.
Things to look out for during the consultation would be the symmetry of his post-surgical patients, the recovery period and the quality of the scar at 3-6 months post-operatively.
It would be even better if he can show you pictures of revision ptosis surgery he has handled from other doctors - it would show that he is able to handle complex cases and would know what to do should outcomes be less than desirable.
Medisave or insurance claim depends on an opthalmologic assessment as mentioned on your visual field and MRD1. The clinic you visit should have a partner ophthalmologist who can do this for you. In addition, the clinic will be able to efile for you should a claim be possible.
Dr Samuel Ho
In order for a doctor to advise on the best course of treatment for you, you will require an in person consultation.
There are many methods of ptosis correction surgery available. The best method for you will depend on how severe the ptosis is and how invasive the approach you are comfortable with.
Ptosis can be corrected using incisional methods or partial incision methods. The surgery is done under local anaesthetic. It may be medisave claimable, but only if your vision is obstructed. In Singapore, this will need to be verified by an ophthalmologist. Hope this helps.
The good news is that visually significant ptosis (droopy eyelids) that obscures the visual axis may be eligible for use of medisave or integrated insurance plans to cover the cost of surgical correction for ptosis.
This will require a visit to your oculoplastic surgeon who is an ophthalmologist.
A comprehensive examination will be performed, including photos taken and an automated visual field to determine the extent and severity of droopiness and potential improvement after surgery.
You should have a detailed discussion with your oculoplastic surgeon who will best advise you if you are eligible for ptosis correction using Medisave, and which option of surgical correction is most suitable for you.
Best of luck!