Ptosis (Drooping Eyelid)
On this page: Risks of surgery for ptosis
Ptosis (TOE-sis) refers to drooping of an upper eyelid of one or both eyes. The droop may be barely noticeable, or the lid can descend over the entire pupil. Ptosis can affect both children and adults, but usually occurs because of aging.
Ptosis Symptoms and Signs
The most obvious sign of ptosis is the drooping eyelid. Depending on how severely the lid droops, people with ptosis may have difficulty seeing. Sometimes people tilt their heads back to try to see under the lid or raise their eyebrows repeatedly to try to lift the eyelids.
The degree of droopiness varies from one person to the next. If you think you may have ptosis, compare a recent photo of your face with one from 10 or 20 years ago, and you'll likely see a difference in the eyelid skin.
Ptosis can look similar to dermatochalasis, a group of connective tissue diseases that cause skin to hang in folds. These diseases are associated with less-than-normal elastic tissue formation. Your eye doctor should be able to tell whether or not this is the cause of your drooping eyelids.
Top: normal eyelid position. Bottom: ptosis (both eyes).
What Causes Ptosis?
This condition also can be caused by a problem with the muscles lifting the eyelid, called levators. Sometimes a person's facial anatomy causes difficulties with the levator muscles.
An eye tumor, neurological disorder or systemic disease like diabetes are other causes of drooping eyelids.
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Surgery usually is the best treatment for drooping eyelids. Your surgeon tightens levator muscles to lift eyelids, giving you improved vision and appearance. In very severe cases involving weakened levator muscles, your surgeon attaches the eyelid under the eyebrow. This allows the forehead muscles to substitute for levator muscles in lifting the eyelid.
Risks of Surgery for Ptosis
After surgery, the eyelids may not appear symmetrical, even though the lids are higher than before surgery. Very rarely, eyelid movement may be lost.
It is important to choose your surgeon carefully, since poorly done surgery could result in an undesirable appearance or in dry eyes from lifted eyelids not closing completely.
Before agreeing to ptosis surgery, ask how many procedures your surgeon has done. Also ask to see before-and-after photos of previous patients, and ask if you can talk to any of them about the experience.
Ptosis in Children
Children born with moderate or severe ptosis require surgical treatment in order for proper vision to develop. Failure to treat ptosis can result in amblyopia (diminished vision in one eye) and a lifetime of poor vision.
All children with ptosis, even mild cases, should visit their eye care practitioner every year. The eyes change shape as they grow, and sometimes vision problems can develop if the ptosis worsens.
Judith Lee also contributed to this article.
[Page updated January 2016]