How Serious Is Eyelid Lag?
Just what is eyelid lag? Eyelid lag is said to occur when movement of the eyelid is delayed when the eye moves downward. Eyelid lag is sometimes acquired and sometimes congenital, though it may be a year or more before it is detected in those cases where it is congenital.
Eyelid lag can be so mild as to be virtually unnoticeable, or in some cases severe enough to affect one's vision. Whether it is acquired or congenital, it often occurs in incremental steps, and the person affected with it may not notice any changes. Very often a change in one's appearance is recognized before any noticeable change in vision occurs. The condition does not appear to favor any race or gender.
The condition is sometimes first noticed as it can give the affected person a sleepy or tired look. This look is due to an eyelid that droops slightly; a condition called ptosis, and can affect one eye or both eyes. In congenital cases, the condition will sometimes appear to be inherited, as older family members may have the disorder, or photographs of previous generations my show indications that the condition runs in the family.
Hyperthyroidism - There is a close connection between eyelid lag and a thyroid disorder. Although a thyroid condition will not necessarily cause eyelid ptosis, and ptosis or lag can be brought about by things other than a thyroid disorder, such as trauma, most cases of eyelid lag have their roots in a thyroid disorder, specifically hyperthyroidism. The eyelid lag condition is often first noticed when in the course of undergoing tests for hyperthyroidism, the eyes are examined.
When hyperthyroidism is the cause of eyelid lag, the eye problem usually goes away once the hyperthyroidism has been successfully treated, especially in those cases where the thyroid gland has had to be removed. In other instances, the eyelid problem eventually goes away on its own, although whether this actually will happen or how long it may take is usually not predictable. Doctors are sometimes reluctant to treat eyelid lag surgically although it can be done, since if the condition is in the process of remission, any surgery could cause complications which could be permanent.
Allergens And The Immune System - When the thyroid gland is involved, not only may the affected person experience eyelid lag, but may also experience problems such as uncontrolled blinking, or a failure of the lid to close completely. On occasion, the lower lid may be affected as well, and lag as one's gaze is directed in an upward direction.
When the thyroid is involved, anything that may injure the immune system has the potential for contributing to the eye problem. This can range from allergens, like cigarette smoke or other air pollutants, nutritional or dietary deficiencies, or a diet too rich in sugars and/or saturated fats. Stress can also be a contributing factor. As was mentioned above, when a problem with the thyroid or with the immune system can be rectified, the eyelid condition will also often improve.
Thyroid Eye Disease - When a thyroid condition is the actual cause of eyelid lag, the eye condition is usually referred to as Thyroid Eye Disease, or TED. TED is normally not a permanent condition, usually having a run of several years before disappearing, but the allergens and other factors mentioned above can serve to prolong the condition, sometimes for many more years. One of the best preventive actions against non-congenital eyelid lag is to avoid lifestyle choices which may encourage hyperthyroidism. If it does occur, there are medications available to treat and often cure the disorder, and surgery is usually only necessary in extreme cases.