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Ptosis: Who it affects and when to seek help

  1. Ptosis causes
  2. Ptosis treatments
  3. When to seek help
closeup of woman's eyes with ptosis eyelid drooping

What is ptosis?

Ptosis (also called blepharoptosis) is defined by eyelid drooping. 

While ptosis (“tō-səs”) is most often seen in older individuals, the condition can be spotted in people of any age, and there is more than one type of ptosis. Drooping eyelids can be present at birth, known as congenital ptosis, or it can develop later in life and be categorized as acquired ptosis.

Ptosis can be observed in one eye (unilateral ptosis) or both eyes (bilateral ptosis). The severity of the condition varies from subtle, unnoticeable droopy eyelids, to the point that vision is obstructed because the eyelid is sagging over the pupil

While ptosis is painless, it can be a cosmetic annoyance and potentially dangerous if vision is affected.

Who ptosis affects

Ptosis can affect anyone. There is no significant evidence that shows a specific gender or race is at a higher risk of having ptosis, although droopy, heavy eyelids are seen more often in older adults.  

A research study published in the journal Ophthalmology found that congenital ptosis occurs in one out of every 842 births, making the condition’s prevalence in children higher than one might think. The study also mentioned that ptosis is significantly more likely to involve the left eye than the right.  

SEE RELATED: Celebrities with ptosis

Ptosis causes

The cause of ptosis can be chalked up to a problem with the muscles that lift the eyelids, called levators. This may be due to a nerve problem, trauma or other underlying cause. 

In some cases, ptosis also can be caused by a growth or stye in the eyelid

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Top: normal eyelid position. Bottom: ptosis (both eyes).

Children may exhibit ptosis symptoms because the levator muscles responsible for opening the eye did not develop completely or properly. Children with ptosis often tilt their heads back in order to see past their hooded eyelids. Over time, this compensation can lead to issues with the head and neck.

Another possible outcome of ptosis in children is amblyopia, also called lazy eye, which hinders a child’s vision development and, in severe cases, can lead to permanent vision loss. 

In older individuals, age and excessive eye rubbing can lead to stretched or weakened eye muscles, resulting in ptosis. Sagging eyelids are also a potential aftereffect of corrective eye procedures, like cataract surgery. 

More serious causes of ptosis are underlying conditions, like a neurological issue or an eye movement disorder. In rare and unfortunate cases, ptosis can be a sign of stroke, brain tumor, or cancer of the nerves or muscles.

READ MORE: Ptosis test

How to treat ptosis

Treatment for ptosis depends on the severity of the condition and the preferences of the patient. Many cases of ptosis are minor and will not negatively affect an individual’s sight or health.

However, those whose vision is impaired by the condition will likely require ptosis surgery (blepharoplasty). Some with minor ptosis but who are unhappy with their eyes’ appearance may also elect to undergo this procedure.

Children with congenital ptosis are typically encouraged to have surgery before their droopy eyelid(s) worsen or their vision becomes affected. 

Surgery for ptosis usually involves tightening the levator muscles and removing extra skin, fat and tissue in the eyelid. In rare circumstances, in which the levator muscles are severely weak, the surgeon will attach the eyelid beneath the eyebrow. The forehead muscles are then used to lift the eyelid, as opposed to the levator muscles. 

When to seek help

While droopy eyelids are usually harmless and no cause for alarm, there are certain instances in which an eye doctor should be seen promptly. According to professionals at Harvard Health, these circumstances include:

  • A droopy eye that is accompanied by stroke symptoms like blurred vision, muscle weakness in the face, arms and legs, severe headache and/or trouble speaking.

  • A droopy eyelid that appears suddenly or develops rapidly over a short period of time.

  • Eye redness and/or pain are also experienced, along with a fever and difficulty moving the eye.

Parents are recommended to observe their baby’s eyes to see if the eyelids look uneven, if their eyes appear two different sizes, or if they frequently tilt their head up in order to see. These are all indications of ptosis and should be addressed by an eye care professional. 

If you notice eyelid drooping in your child — or any other eye or vision-related change — an appointment with an eye doctor is indicated. 

Older individuals whose vision is obstructed by their eyelids due to age-related drooping also should schedule an appointment with their eye doctor. An eye care professional can discuss treatment options and establish whether surgery is right for you.

HAVE MORE QUESTIONS ABOUT DROOPING EYELIDS? See our ptosis FAQs.

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