Droopy Eyelid (Ptosis)

Nearly everyone experiences droopy eyelids before they drift off to sleep, but if your upper lid is constantly hanging over your eye, you may have a condition called ptosis, meaning an abnormally low-hanging upper eyelid.

It can develop as a normal part of aging or be caused by stroke, cancer, neurological problems, and other medical conditions. Some people are born with a droopy eyelid that can co-occur with other eye problems. A droopy eyelid can interfere with your field of vision and should be seen by a healthcare provider. Treatments, including minor surgery and prescription medications, can help with your droopy eyelid. 

Continue reading to learn more about droopy eyelids, such as what can cause the condition and treatments, including a medication that was only recently approved. 

Symptoms of Droopy Eyelid

The primary symptom of ptosis is a droopy upper eyelid that hangs over the eye. If your droopy eyelid is minor, it might not interfere with your vision, but in severe cases the eyelid can cover the pupil, making it difficult to see. A droopy eyelid can occur in just one eye, or both. 

In addition to a droopy eyelid, you may experience:

• Dry eyes
• Watering eyes
• Aching or throbbing around the eyes
• Trouble blinking or closing the eye
• Crossed eyes
• Double vision
• Eye fatigue
• Muscle strain in the head or neck 

Kids with a droopy eyelid may experience addition symptoms including:

• Delays in walking or crawling
• Tilting their head back to try to see “under” the eyelid
• Other vision problems including nearsightedness, farsightedness, or astigmatism
• Headaches or dizziness 

Causes of Droopy Eyelid

Some people are born with a droopy eyelid, while others develop the condition later in life. The most common causes of a droopy eyelid are:

• Aging, as the levator muscle becomes stretched out over time (the most common cause of a droopy eyelid) 
• Congenital ptosis, detectable at birth or soon afterward 
• Medical conditions, including neurological conditions like multiple sclerosis or a stroke

How to Treat a Droopy Eyelid

The most common course of treatment is surgery. There are a few different types of surgery that treat a droopy eyelid, and your healthcare provider may recommend one or more of the following:

• Ptosis repair: During this surgery, a small incision is made in your eyelid and tightens the levator muscle with stitches. This is done under local anesthetic. 
• Blepharoplasty: This surgery removes excess skin from the eyelid, which may be contributing to droopiness. 
• Frontalis sling fixation: This surgery is used when the levator muscle doesn’t have any functioning. The surgeon attaches the eyelid to the frontalis muscle, which is above the eyebrow. This muscle can then be used to lower or raise the eyelid. 

In addition to surgery, a prescription eye drop called Upneeq (oxymetazoline hydrochloride ophthalmic solution) was approved by the Food and Drug Administration (FDA) in 2020 to treat droopy eyelids.

The drops are only for adults with mild to moderate ptosis. They can’t be used by children. You should ask your healthcare provider about whether they would work to treat your droopy eyelid. 

Complications and Risk Factors Associated With Droopy Eyelid

If a droopy eyelid isn’t corrected, it may affect your vision. You might experience vision loss or a reduced field of vision. In children, a droopy eyelid can lead to headaches, dizziness, and developmental delays. It’s always best to see a healthcare provider about your droopy eyelid, especially if it begins to affect your sight. 

Are There Tests to Diagnose the Cause of a Droopy Eyelid?

Ptosis should be diagnosed by an ophthalmologist, or eye doctor. They will examine your eye and measure your eyelid droop and your muscle strength. They may also test your vision to see how the droopy eyelid is affecting that. 

When to See a Healthcare Provider

You should always see a healthcare provider if you have a droopy eyelid. This is a condition that can become worse with time, affecting your vision and muscles. While it might seem minor, it’s important to seek a professional diagnosis, and work with a healthcare provider to develop the right treatment plan for you. 

Summary

A droopy eyelid isn’t just a cosmetic concern: it’s a medical condition called ptosis. If you have a droopy eyelid you should talk to a healthcare provider, especially if it is affecting your vision. A droopy eyelid is usually treated with surgery under a local anesthetic. It’s a minor procedure that can help restore your full field of vision and prevent other complications.