
Hängende Augenlider, in der medizinischen Fachsprache auch als Ptosis bezeichnet, zeigen sich an beiden oder auch nur einem Oberlid. Sie stellen nicht nur ein rein ästhetisches Problem dar, sondern können in stark ausgeprägten Fällen auch das eigene Sichtfeld einschränken.
Im Erwachsenenalter ziehen hängende Augenlider noch andere Probleme nach sich, wie etwa Fehlhaltungen und draus resultierende Kopf- und Nackenschmerzen. Auch bei Kindern ist eine Ptosis möglich, die unbehandelt eine Fehlsichtigkeit bedingen kann.
Hängendes Augenlid – was sind die Ursachen?
Die Ursachen für hängende Augenlider sind ganz unterschiedlich, abhängig davon, ob es sich um eine angeborene oder eine erworbene Form der Ptosis handelt:
Die Angeborene Ptosis
Eine angeborene Ptosis hat meist eine Unterentwicklung im Hirn zur Ursache. So funktioniert die Übertragung von Nervenimpulsen auf Muskeln in bestimmten Bereichen nicht. Die Folge sind die hängenden Augenlider, meist auf beiden Seiten. Hinter einer angeborenen Ptosis können auch unterentwickelte Muskeln im Bereich der Augen stecken. Diese Schwäche der Lidhebermuskel macht es nur schwer möglich, die Lider anzuheben.

Die Erworbene Ptosis

Bei einer erworbenen Ptosis ist meist eine Nervenlähmung die Ursache. Der betroffene Nerv ist entscheidend an der Bewegung der Augen beteiligt, wobei die Lähmungen durch verschiedene Faktoren ausgelöst werden, wie etwa:
- Schlaganfall
- Hirnhautentzündung
- Infektion im Bereich des Gehirns
Eine andere Form der erworbenen Ptosis stellt das Horner-Syndrom dar, welche eine Schädigung des Nervensystems bezeichnet. Nicht nur hängende Augenlider sind dann die Folge, sondern auch eine Pupillenverkleinerung und das Einsinken des Auges. Weitere Ursachen, die eine erworbene Ptosis bedingen:
- bestimmte Formen der Muskelerkrankung, wie etwa Muskelschwund
- Verletzungen traumatischer Art
Hängendes Augenlid – die Diagnose:
Im ersten Schritt wird eine Anamnese durchgeführt, bei der natürlich die Ausprägung und die Ursache der hängenden Augenlider eine Rolle spielt. Dazu ist im zweiten Schritt eine genaue Untersuchung der Augen erforderlich. Versteht der Verdacht auf eine Muskelschwäche, so werden noch weitere Tests benötigt. Dazu zählt beispielsweise der sogenannte Simpson-Test. Andere Diagnosemöglichkeiten stellen bildgebende Verfahren dar, wie CT und MRT.
Behandlung – wie werden hängende Augenlider entfernt?
Bei der angeborenen Form der hängenden Augenlider kommt eine operative Straffung und anschließende Anhebung der Lider infrage. Eine erworbene Ptosis erfordert meist ein anderes Vorgehen, abhängig von den ursächlichen Faktoren. Steckt eine Muskellähmung oder eine Nervenverletzung dahinter, so ist es möglich, dass die Ptosis nach einigen Monaten von alleine wieder verschwindet. Alternativ dazu ist ebenfalls eine operative Korrektur der Augenlider möglich.
Eine Augenlid-OP zählt zu den am häufigsten durchgeführten Eingriffen im Bereich der plastischen und ästhetischen Chirurgie. In der Regel werden die Kosten für die OP von der Krankenkasse übernommen, vorausgesetzt, es liegt eine medizinische Indikation vor. Eine Oberlidkorrektur bzw. eine Lidstraffung aus rein ästhetischen Gründen müssen Sie selber zahlen.
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