sagging eye syndrome (SES) is a condition characterized by the gravitational drooping of the outer edge of one or both upper eyelids, which may extend upwards to form a 'baggy眼' or 'pseudoptosis'. This drooping can occur regardless of the patient's age, gender, or ethnic background. SES is often associated with vertical strabismus, meaning that the affected eye deviates either vertically or horizontally away from the opposite eye. It can also be associated with superior oblique myopia, which is a form of farsightedness that causes the eye to focus behind the retina, further contributing to the downward deviation.
Causes
The precise cause of sagging eye syndrome is unknown, but several factors are thought to contribute to its development. One theory suggests that the syndrome is caused by normal aging changes in the connective tissue that support the extraocular muscles and the orbital connective tissues. Specifically, there is a degradation of the tendons that attached the superior rectus muscle to the upper eyelids, leading to a change in the position of thelevator palpebrae superiores, causing the upper eyelids to fall inferiorly. Additionally, there is degeneration of the inferior rectus muscle, which can result in a small angle esotropia, a small angle hypotropia, or both.
