upper eyelid ptosis exercises

[physiobob]

Hello, I am trying to develop levator palpebrae exercises (low-rep, isometric contractions) for congenital ptosis, because I do not want to go ahead with surgery. Assuming this is possible in my case, which gaze (upward or downward) should one adopt to allow the best contraction of the levator muscle, ie: where all possible motor units are recruited at once? I assume the recti muscles, when looking up, facilitate the upper eyelid to open, thus taking some of the slack and preventing the levator from working to its full potential. So maybe looking down would be most efficient?

Any other suggestions as to how to improve or develop such exercises would of course be very appreciated. Thanks!

I wouldn't think looking up is going to help as much as down etc as a ptosis is an inability to close the eyelid. I have use muscle stimulation to assist with this following facial palsy. Also simple blinking type exercises would perhaps stimulate it more to close that would the moving of the actual eyeball.

If this condition is congenital did it develop or have you always had it? If you have had say 20 years of ptosis then I would think surgery is a good option. I have seen it succeed rather well in facial palsy's that don't fully recover.

Think of things that force the eyes to close automatically. These might help.. You could think laterally and perhaps shine some 'glaring' light into the eye to see if it makes them close as would happen when looking at the sun.

Additionally I would consult an orthoptist on working out the best exercises. They are afterall the 'physio's of the eyes' and they can offer very skilled and specific exercises.