Ptosis repair often is covered by insurance, depending on if it is causing visual obstruction and the degree of ptosis. Depending on your insurance plan, the criteria will vary, and additional testing may be required. Our team will submit your case for prior authorization prior to your procedure and you will receive a call from our office to confirm whether or not your insurance has approved this procedure for you.

Dr. Pelton and Dr. Yu will carefully evaluate you at your appointment to see if insurance requirements can be met. 

Ptosis can be corrected through surgery, and when the droopy eyelid is blocking your vision, often this procedure can be covered by your insurance. Surgical approaches include anterior, posterior, and, in cases where the eyelid lifting muscles do not function normally, include flaps or slings fashioned to your eyebrow lifting muscle. There are advantages and disadvantages to each type of procedure. For example, the internal ptosis repair, also called Müller's Muscle-Conjunctival Resection (MMCR), has the benefit of having no visible scar as all incisions are made on the inside of your eyelid. However, this procedure is only effective for those with mild to moderate ptosis, and some patients with other eye conditions such as glaucoma may not be candidates for this approach. Your surgeon will thoroughly examine you and discuss with you the best approach to your repair.

Some patients have congenital ptosis, meaning that the eyelid lifting muscles did not develop normally in utero. This causes drooping of the eyelid that is noticeable within the first year of life. More commonly this is related to muscle dysgenesis (muscle fibers are replaced by abnormal fatty / fibrotic tissue), but can also be caused by abnormal nerve innovation to the eyelid lifting muscles. Correction of congenital ptosis can occur during childhood if it is causing visual obscuration or concern for abnormal visual development, or in adulthood. Surgical correction of congenital ptosis is typically performed via either a levator resection, frontalis flap, or frontalis sling. Your doctor will discuss the pros/cons of each approach with you to select the optimal approach for you (or your child).