Eyelid ptosis, also called blepharoptosis or droopy eyelid, is a condition that causes the upper eyelids to droop over the eyes. While eyelid ptosis is not always a medical problem, it can become a concern if your field of vision is affected or if you are experiencing other symptoms that get in the way of daily life, such as chronic eye irritation or aching eyes.
True eyelid ptosis can often be mistaken for other conditions such as hooded eyelids, though if left untreated, drooping eyelids can lead to other eye problems down the road. Use this guide to learn more about what eyelid ptosis is, how to tell if you might have it and what you and your doctor can do to correct it.
What Is Eyelid Ptosis?
Eyelid ptosis is characterized by drooping upper eyelids, often affecting vision. It can affect both children and adults and can be present in one or both eyelids.
Eyelid ptosis, or droopy eyelid, is sometimes confused with a similar condition called hooded eyelids. Hooded eyes are a hereditary trait caused by excess skin beneath the eyebrows, making the upper eyelids and crease not visible when the eyes are open. Droopy eyelids, on the other hand, happen when the skin that makes up the upper eyelids — not the skin below the eyebrows — droops below the eyes. While some level of impaired vision is common with eyelid ptosis, vision problems are not usually a concern with hooded eyes.
Both hooded eyelids and eyelid ptosis can be caused by genetics and therefore can be present from birth. However, eyelid ptosis can also occur later in life. This distinguishes the two types of eyelid ptosis:
- Congenital ptosis is caused by genetics and is present from birth.
- Acquired ptosis is caused by secondary factors and occurs later in life, often as a result of the natural aging process.
What Causes Eyelid Ptosis?
As noted above, eyelid ptosis can be hereditary and therefore present at birth, or it can be acquired later in life. In both cases, a muscle in the upper eyelid called the levator muscle is weakened and unable to lift the eyelid as well as it should. Some of the most common reasons that eyelid ptosis may develop in adulthood include:
- Natural aging
- Eye injuries
- Complications with styes
- Medical conditions like Horner syndrome or myasthenia gravis
- Previous eye surgeries
Lifestyle factors like sun exposure, smoking and obesity may increase the risk of developing drooping eyelids with age. Eyelid ptosis also appears to affect more men than women, although both men and women can struggle with this condition.
How Do You Know If You Have Droopy Eyelids?
In most cases, eyelid ptosis is fairly easy to recognize in both children and adults, as the upper eyelid clearly droops below the lash line. Others signs of eyelid ptosis include:
- Impaired field of vision
- Excessive rubbing of the eyes
- Increased tearing
- Tired or achy eyes
- Tipping the head back in order to see properly
If you notice any of these eyelid ptosis symptoms, talk with your doctor or an eye specialist for an accurate diagnosis and treatment recommendations.
Can Eyelid Ptosis Be Prevented?
No, most cases of eyelid ptosis are very difficult if not impossible to prevent. Congenital eyelid ptosis caused by genetics cannot be prevented, as children are born with this condition. While adults can take some steps to reduce their risk of developing acquired eyelid ptosis later in life, such as wearing sunglasses and following healthy lifestyle habits, most cases of this type of ptosis are simply caused by the natural aging process.
How Are Drooping Eyelids Treated?
Drooping eyelids do not always need to be treated. However, if they are affecting your vision or causing eye pain or irritation, drooping eyelids likely need to be medically addressed to avoid further complications in the future. If left untreated, moderate to severe drooping eyelids could lead to astigmatism, lazy eye or neck problems caused by using a “chin-up” position in order to see.
If your eye care specialist believes you could benefit from droopy eyelid treatment, he or she may recommend eye drops as a nonsurgical option or eyelid ptosis surgery, depending on the severity of your symptoms.
While prescription eye drops are available to help the levator muscle work better, this treatment option isn’t always effective and does require daily use. Droopy eyelid surgery, on the other hand, offers a long-term solution and can correct virtually all forms of eyelid ptosis.
The best droopy eyelid treatment for you will depend on the type of ptosis you have and the severity of your symptoms. Work closely with an eye specialist or plastic surgeon experienced with eye surgeries to help you determine if a surgical solution could be right for you.
Dr. Raghu Athré is one of the few cosmetic and reconstructive surgeons in Houston who is a double board certified Facial Plastic surgeon, certified in Otolaryngology and Head/Neck Surgery.
