Kristen Stewart's eyes

It is amazing to me how variable the symptoms are when someone has "bedroom eyes" otherwise known as ptosis. Take Kristen Stewart, she is apparently born with it and it does not seem to bother her. Someone else who develop the condition as a result of aging (involutional ptosis) would be complaining bitterly of heavy eyelids, trouble keeping the eyes open especially towards the end of the day or during reading. These are referred to as being "symptomatic".  Symptomatic individuals with age-related ptosis tends to compensate for the drooping by raising the eyebrows to unload the eyelids, usually resulting in prominent forehead wrinkles.

We measure the severity of the ptosis by noting the distance between the central light reflex (the little white dot visible at the center of her pupil) and the edge of the upper lid. This measurement is known as MRD (marginal reflex distance).  In Kristen's case, the MRD is 1 mm on the right and 1mm on the left. We usually recommend surgical correction for symptomatic patients with MRD's anywhere from 3mm to 1mm and below.  

 

There are two main approaches to correcting ptosis. Some doctors prefer a posterior approach where a strip of mucosal tissue on the backside of the lid is removed and the edges sewn back together. I like the anterior approach where the levator muscle insertion, the muscle that elevates the eyelid, is shortened. This makes more sense to me because it is the levator insertion which caused the problem in the first place.

 

Going back to Ms Stewart, she and her fans may like her bedroom eyes which is fine. Just because someone has ptosis does not mean it needs treatment. It is not cancer, we don't have to do anything about it. To me she just looks tired and sleepy and I fail to see anything alluring about her eyes. Every time I see her photo, I am just itching to fix it. You know what they say. If you have a hammer, everything starts to look like a nail.

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