Ptosis surgery

Your child's doctor has recommended surgery to correct ptosis.

Surgery for ptosis

There is no single type of surgery for ptosis. Your eye doctor will explain what will happen during the surgery that is chosen for your child.

Before the surgery, your child will have a medicine called a general anaesthetic. This will make sure your child sleeps through the operation and does not feel any pain.

The operation is done as a day surgery. This means that your child will not stay in the hospital overnight afterwards.

What to expect after your child's surgery

Pain or discomfort

Your child may have some pain in the operated eye. Ask your child's eye doctor if you can give medicine to relieve the pain.

Eye patch

A tight patch is usually put on your child's affected eye after the surgery and removed the next day at home. Your eye doctor will tell you when to remove the patch. It is important to leave the patch on the first night to help with healing and avoid bleeding.

Puffy eyelids and bruising

Your child's eyelids may be puffy, bruised and swollen after the surgery. You may notice small stitches on the operated eyelid(s). The stitches will dissolve over time, usually in around one to two weeks. However, the stitches may last for over a month.

Pink discharge or bleeding

Your child may have small amounts of slightly pinkish discharge or bleeding from the operated area for the first day. If this happens, you can stop the bleeding by gently wiping the operated area with a clean gauze or clean towel and applying gentle pressure for a few minutes. Call your eye doctor if the discharge or bleeding continues or if the discharge becomes yellow or green.

Eyelid height

Your child's eyelids may still look uneven after the operation. It may take several weeks for your child's eyelid to reach its final height.

How to care for your child after ptosis surgery

Cool water compresses

Some eye doctors will suggest putting cool water or ice water compresses on the eyes to ease discomfort and reduce the swelling after surgery. Ask your child's eye doctor if your child can have cool compresses.

To make a cool compress, follow these steps:

1. Always wash your hands before and after you touch your child's eyes.
2. Fill a clean container with cool water. Cool tap water is fine. If you have well water, boil it and cool it in the refrigerator before you use it.
3. Soak a clean face cloth in the water.
4. Squeeze any extra water out of the cloth, then place the cloth on the swollen eye(s).
5. Leave the cloth on for no more than two minutes at a time.
6. Repeat a few times.

Ask the eye doctor how often your child can have a cool compress. Several times a day for the first one to two days is often fine.

Sleeping

If you can, try to let your child sleep with their head raised on one or two pillows. This will help to bring down any swelling and puffiness. For babies, toddlers and pre-school children, put the pillows under the mattress to raise the head of the bed.

Eye ointment and eye drops

Your child will need antibiotic ointment on the operated eye(s). Make sure you get the prescription from the eye doctor and follow the instructions for applying the ointment.

Sometimes, your eye doctor will also order antibiotics or a combination of cortisone and antibiotic drops for the operated eye(s). If your child needs eye drops, your child's eye doctor will give you a prescription. It is very important to put in the eye drops correctly.

Gentle play only for the first week

For the first week after the surgery, your child can do light activities such as playing gently indoors, using computers and watching TV.

During this time, your child will need to avoid rough activities, sandbox play or contact sports such as soccer, hockey or anything else that would cause them to bump into another child.

Your child should also avoid bending and any activities that could cause them to get out of breath. Ask your child's doctor when your child can return to normal activities.

Baths and showers

Ask your child's eye doctor about baths and showers. Some eye doctors prefer your child to take a bath instead of a shower for the first week after surgery.

Please check with your child's eye doctor if it is OK to wash your child's hair, as the water could run over their eyes. If you can wash your child's hair, make sure you avoid getting soap or shampoo in their eyes.

Only wash your child's face with a clean face cloth and water.

School and day care

Generally, children should not go to school or day care for the first one or two days after the surgery, sometimes longer. Please check with your child's eye doctor. Tell your child's caregiver or teacher about any activities that your child must avoid while the eye heals.

Swimming

Swimming is not allowed for at least one week after the surgery. Please ask your child's eye doctor when your child can return to swimming.

Follow-up appointments

You will need to bring your child to a follow-up appointment, usually one to two weeks after the operation.

Write the date and time of the follow-up appointment here:

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Sometimes, your child may need to have a second operation. The eye doctor will discuss this with you.

When to call the doctor

Call your child's eye doctor if, after the operation:

• your child cannot see properly
• your child has a fever
• you see a lot of bleeding in your child's eye patch/dressing
• your child's pain gets worse and does not improve despite Tylenol
• your child's eye suddenly gets more puffy
• your child's eye starts bleeding
• there is any green or yellow discharge
  

If your child's operation took place at The Hospital for Sick Children, please page the ophthalmology resident on-call. You can page the ophthalmology resident on-call through The Hospital for Sick Children Locating at 416-813-7500.

American Academy of Ophthalmology: What is ptosis?

American Association for Pediatric Ophthalmology & Strabismus: Ptosis