Ptosis crutch question

[Jalane]

Does anyone out there have experience measuring and fitting for a ptosis crutch?

[Jacqui]

Yes, but I'm a looong way away from you.

[Jacqui]

I make mine from paper clops and shrink tubing, so I just eyeball everything.

[Fezz]

What questions do you have?

[Fezz]

Start with this info packed thread by one of our now gone Optiboarders:

http://www.optiboard.com/forums/show...s-made-by-Chip........

[Fezz]

And here:

http://www.eyecarebiz.com/article.aspx?article=50293

[Chris Ryser]

Ptosis is an abnormally low position (drooping) of the upper eyelid. The drooping may be worse after being awake longer, when the individual's muscles are tired. This condition is sometimes called "lazy eye", but that term normally refers to amblyopia. If severe enough and left untreated, the drooping eyelid can cause other conditions, such as amblyopia or astigmatism. This is why it is especially important for this disorder to be treated in children at a young age, before it can interfere with vision development.

Ptosis occurs when the muscles that raise the eyelid (levator and Müller's muscles) are not strong enough to do so properly. It can affect one eye or both eyes and is more common in the elderly, as muscles in the eyelids may begin to deteriorate. One can, however, be born with ptosis. Congenital ptosis is hereditary in three main forms.[1] Causes of congenital ptosis remain unknown. Ptosis may be caused by damage/trauma to the muscle which raises the eyelid, or damage to the nerve (3rd cranial nerve (oculomotor nerve)) which controls this muscle. Such damage could be a sign or symptom of an underlying disease such as diabetes mellitus, a brain tumor, and diseases which may cause weakness in muscles or nerve damage, such as myasthenia gravis. Exposure to the toxins in some snake venoms, such as that of the black mamba may also cause this effect.
Ptosis can be caused by the aponeurosis of the levator muscle, nerve abnormalities, trauma, inflammation or lesions of the lid or orbit. [2] Dysfunctions of the levators may occur as a result of a lack of nerve communication being sent to the receptors due to antibodies needlessly attacking and eliminating the neurotransmitter. [3]
Ptosis may be due to a myogenic, neurogenic, aponeurotic, mechanical or traumatic cause and it usually occurs isolated, but may be associated with various other conditions, like immunological, degenerative, or hereditary disorders, tumors, or infections [4]
Acquired ptosis is most commonly caused by aponeurotic ptosis. This can occur as a result of senescence, dehiscence or disinsertion of the levator aponeurosis. Moreover, chronic inflammation or intraocular surgery can lead to the same effect. Also, wearing contact lenses for long periods of time is thought to have a certain impact on the development of this condition.
Congenital neurogenic ptosis is believed to be caused by the Horner syndrome. [5] In this case, a mild ptosis may be associated with psilateral ptosis, iris and areola hypopigmentation and anhidrosis due to the paresis of the Mueller muscle. Acquired Horner syndrome may result after trauma, neoplastic insult, or even vascular disease.
Ptosis due to trauma can ensue after an eyelid laceration with transection of the upper eyelid elevators or disruption of the neural input.[6]
Other causes of ptosis include eyelid neoplasms, neurofibromas or the cicatrization after inflammation or surgery. Mild ptosis may occur with aging.

Treatment
Aponeurotic and congenital ptosis may require surgical correction if severe enough to interfere with vision or if cosmesis is a concern. Treatment depends on the type of ptosis and is usually performed by an ophthamolic plastic and reconstructive surgeon, specializing in diseases and problems of the eyelid.
Surgical procedures include:

• Levator resection
• Müller muscle resection
• Frontalis sling operation

Non-surgical modalities like the use of "crutch" glasses or special Scleral contact lenses to support the eyelid may also be used.
Ptosis that is caused by a disease will improve if the disease is treated successfully.

[Jalane]

Specifically, I'm looking for information on how to measure the patient to give them the best fit. I will be using a metal frame for this patient.

[Robert Martellaro]

And here:

http://www.eyecarebiz.com/article.aspx?article=50293

I had a Ptosis Rx about 3 months ago. Last one before that was about twenty years. The only ones we'll see nowadays will be due to disease- if treatment is sucessful then be prepared to remove the crutch. This article was a very helpful refresher.

Here's another-

http://www.eyecarebiz.com/article.aspx?article=103024

Note the emphasis on measuring the depth of the crutch. I sent mine to Hilco. Fee was reasonable, prompt service, and good quality. BTW, I measured from the top of the eyewire to the fold, about 20mm I believe, but Hilco was not prepared to use this information. However, I wouldn't worry too much about this measurement- the metal was quite adjustable, and if the frame is a suitable size, you should have no problems accommodating most occular structures. Have fun, and just be glad you don't have to do a moisture chamber.

[DragonLensmanWV]

I had a Ptosis Rx about 3 months ago. Last one before that was about twenty years. The only ones we'll see nowadays will be due to disease- if treatment is sucessful then be prepared to remove the crutch. This article was a very helpful refresher.

Here's another-

http://www.eyecarebiz.com/article.aspx?article=103024


Note the emphasis on measuring the depth of the crutch. I sent mine to Hilco. Fee was reasonable, prompt service, and good quality. BTW, I measured from the top of the eyewire to the fold, about 20mm I believe, but Hilco was not prepared to use this information. However, I wouldn't worry too much about this measurement- the metal was quite adjustable, and if the frame is a suitable size, you should have no problems accommodating most occular structures. Have fun, and just be glad you don't have to do a moisture chamber.

It was always a lot easier longer ago than it was when frames started to get bigger. Anyone could put a crutch on a Cambridge - you just soldered it to the top of the eyewire and only small adjustments would need to be made. With your pic one can see how different arrangements must be made due to the top of the frame resting higher than the lid. Kudos to Hilco for the nifty arrangement of affixing the crutch to the bridge.

[hcjilson]

Try this thread

http://www.optiboard.com/forums/show...=ptosis+crutch

[Robert Martellaro]

With your pic one can see how different arrangements must be made due to the top of the frame resting higher than the lid. Kudos to Hilco for the nifty arrangement of affixing the crutch to the bridge.

That's "stock footage" BTW, not the one I fit, although Hilco did place the solder joint on the back. I just wanted the OP to see where the crutch should be positioned.