Brow Ptosis

Excerpt

Brow ptosis is the descent of the eyebrow from its normal anatomical position down to a point at which its appearance is cosmetically displeasing, or visual field deficits develop as a result of excess soft tissue pushing downwards on the eyelid. Most commonly, this condition is seen in the elderly due to age-related involutional change of the facial soft tissues, but brow ptosis may also accompany damage to the frontal branch of the facial nerve, which in turn prevents or impairs the frontalis muscle's elevation of the brow or maintenance of appropriate brow position at rest.

When the brow descends, it compresses the soft tissues of the eyelid and weighs them down, often causing excess skin to prolapse over the lid margin and contact the eyelashes, a condition known as pseudoptosis. While pseudoptosis may be mistaken for true blepharoptosis, distinguishing between them is straightforward: elevating the brow to its correct position will alleviate the issue in pseudoptosis, while the lid margin will remain low in cases of true blepharoptosis. Of course, the two problems may coexist, as the etiopathogeneses are not mutually exclusive.