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PTOSIS
上睑下垂
Ptosis comes from the Greek word that means “to fall”.
Ptosis来自希腊语，意思是“跌倒”。
It is an abnormally low position or drooping of the upper eyelid.
这是一种不正常的低位置或上眼睑下垂。
First let's talk about ANATOMY.
首先让我们谈谈解剖学。
We are able to lift our upper eyelid up with the help of 2 muscles, the main one that does all the work is called Levator Palpebrae Superioris which attaches to the lid structures, including the lid skin causing upper lid crease, through an Aponeurosis, and the minor one is called Muller muscle.
能够帮助我们抬起上眼睑的肌肉主要有两块，一块叫做上睑提肌，它通过腱膜附着在眼睑结构上，包括引起上睑褶皱的盖皮，小的一块肌肉叫做穆勒肌。
Both of them work when they get signals from the brain through different nerves.
它们通过不同的神经从大脑获得信号开始工作。
Any disease affecting them would lead to ptosis or drooping of upper eyelid.
任何影响他们的疾病都会导致上睑下垂。
CAUSES
病因
These include: Acquired, Congenital.
病因有后天的、先天的。
Acquired include
后天的包括
1.Neurogenic
1.神经源性上睑下垂
Basically, there is an innervation defect of the muscles, and because nerves supplying the muscles are not working, the muscles will be unable to work properly.
基本上是因为肌肉有神经支配缺陷，由于供应肌肉的神经不起作用，肌肉就不能正常工作。
2.Myogenic
2.肌源性上睑下垂
a.Impairment of transmission of impulses from the nerve to the muscle at their junction, e.G Myasthenia Gravis.
第一种：从神经到肌肉的神经脉冲传递障碍，如重症肌无力。
b.Myopathies which means pathology of the muscle itself is directly affecting the muscles involved in eyelid lifting.
第二种：肌病是指肌肉本身的病理直接影响到提眼睑的肌肉。
3.Aponeurotic
3.腱膜性睑下垂
Also known as senile Ptosis in which there is age related atrophy of the Levator muscle Aponeurosis.
也被称为老年性上睑下垂，这是一种与年龄相关的提上睑肌腱膜萎缩。
4.Mechanical
机械性睑下垂
Gravitational effect of a mass pulling the lid down, for example due to a tumor.
物体向下拉盖子的重力效应，例如由于肿瘤。
GRADES
等级
Ptosis could be mild (up to 2 mm drooping of eyelid), moderate (up to 3 mm drooping of eyelid), or severe (4 mm or more drooping of eyelid) depending upon the amount of Ptosis present.
根据上睑下垂的程度不同，上睑下垂可分为轻度（眼睑下垂2毫米）、中度（眼睑下垂3毫米）或严重（眼睑下垂4毫米以上）。
SIGNS and SYMPTOMS
体征和症状
The most obvious sign of Ptosis is a drooping eyelid.
上睑下垂最明显的症状是眼睑下垂。
Another sign is when the upper eyelid creases do not line up evenly with each other.
另一个迹象是上眼睑的折痕不均匀地排列。
A child with Ptosis may tip their head back, lift up their chin, or raise their eyebrows to try to see better.
患有上睑下垂的孩子可能会仰起头，抬起下巴，或扬起眉毛，试图看得更清楚。
Over time, these movements can cause head and neck problems.
随着时间的推移，这些运动会导致头部和颈部问题。
TREATMENT
治疗
Treatment consists of A.Surgery in most of cases.
第一种治疗方案通常是手术。
Conjunctival and muller resection, in mild ptosis, achieves 2-3 mm elevation of eyelid.
结膜和穆勒肌切除，对于轻度上睑下垂患者，可使眼睑抬高2-3 mm。
Levator resection, in moderate to severe ptosis, usually done in congenital ptosis, achieves 5 mm elevation of eyelid.
提上睑肌缩短术，通常适用于先天性的中到重度的上睑下垂患者，可以达到眼睑上提5 mm。
Brow suspension in very severe ptosis.
非常严重患者需要采用额肌提吊术。
B.Treat the underlying cause.
第二种治疗根本原因。
For example, in Ptosis due to Myasthenia Gravis or a mechanical cause, treat Myasthenia Gravis or remove the mechanical cause.
例如，由于重症肌无力或机械原因引起的上睑下垂，治疗重症肌无力或去除机械原因。
