What Is Ptosis?

Ptosis is a condition in which the upper eyelid droops over the eye. Sometimes it can interfere with your vision. The condition often affects older people but it can occur in children as well. Ptosis can occur in one eye or both eyes at the same time.

Symptoms of Ptosis

The most obvious sign of ptosis is drooping of the eyelid. Other symptoms include:

• Difficulty closing the eye or blinking
• Tearing
• Eye fatigue
• Trouble seeing (because of this, a person may tilt their head back in order to see under the eyelid)
  

Children with ptosis may have additional symptoms, such as:

• Amblyopia, sometimes called lazy eye because one eye seems to look off in another direction
• Nearsightedness, farsightedness, or astigmatism
• Double, blurred, or distorted vision
• Eye strain, headaches, or dizziness
  

Causes and Risk Factors

In adults, ptosis is often caused by normal aging. Aging can cause the eyelid muscles (called levator muscles) to weaken.

Sometimes people are born with ptosis. This is called congenital ptosis. Congenital ptosis may be caused by problems with the brain or nerves that lead to weakness in the eyelid muscles. Children born with a birth defect or injury that affects the eyes may also have ptosis.

People with eye tumors, diabetes, a history of stroke, cancer, and neurological disorders are at risk for developing ptosis.

Cosmetic treatment with Botox (botulinum toxin A) can sometimes cause ptosis. If you are interested in getting Botox treatments, make sure to find an experienced practitioner.

Diagnosis

An eye doctor will diagnose ptosis by examining your eyelids closely. They will measure the height of your eyelids and the strength of the eyelid muscles.

They may also perform a computerized visual field test to see if your vision is normal. In a visual field test, you are asked to look at a series of flashing lights in a machine, without moving your eyes. When you see a light, you push a button.

Treatment

If you are an adult and are not having trouble seeing or don't mind how your eyelids look, you don't need treatment for ptosis.

The most common treatment for ptosis is a surgical procedure called a ptosis repair. The surgeon numbs the area around your eyelid with a local anesthetic. Then they make a small incision (cut) in the skin on the upper eyelid. They can then tighten the levator muscle with stitches to raise the eyelid. The incision is then closed with more stitches.

A ptosis repair may be done together with a blepharoplasty. A blepharoplasty is a surgery that removes excess eyelid skin. This extra skin can contribute to the droopiness.

Sometimes the eyebrows may be surgically lifted as well. Surgery is usually successful for people with ptosis and improves both vision and appearance.

In September 2020, the first prescription medication used to treat ptosis, called Upneeq, was approved by the Food and Drug Administration.

Upneeq (oxymetazoline hydrochloride ophthalmic solution) comes in the form of eye drops. It causes the levator muscle to contract. This allows the eyelid to open 1 to 2 millimeters wider. It is intended for adults with mild to moderate age-related ptosis. Upneeq is not approved for use in children.

Summary

Ptosis is a condition in which the eyelids droop. This can make it hard to see properly in some cases.

Ptosis is caused by a weakened muscle in the upper eyelid. It can be a result of normal aging or certain medical conditions. Sometimes, people are born with ptosis. Surgery is the most common treatment for ptosis.

A Word From Verywell

If you've noticed that your (or your child's) eyelids seem to be drooping, contact your doctor, especially if you are having difficulty seeing normally. They can refer you to an eye doctor, who can confirm whether you have ptosis.