What is ptosis (drooping eyelid)?

“Ptosis” means drooping. When the upper eyelid droops, it is called blepharoptosis, or upper eyelid ptosis.

Why do people get ptosis (drooping eyelid)?

There are several reasons an eyelid might droop. Some babies are born with ptosis in one or both eyelids. These children must have a thorough eyelid examination.

Ptosis can occur later in life if the muscles or ligaments that normally raise the eyelid are weakened by injury or disease. Sometimes the drooping is a result of damage to the nerves that control the eyelid muscles.

Most ptosis just happens with aging. As a person ages, the skin and muscles of the eyelids stretch and weaken. Sometimes, previous eye surgery speeds up this change because the instruments used to keep the eye open during surgery can stretch the eyelid.

How is ptosis (drooping eyelid) treated?

Treatment usually depends on how well the eyelid muscles are functioning. If the ptosis does not affect vision and the patient does not mind the appearance, the doctor might recommend no treatment at all.

If the ptosis causes a problem with vision, appearance, or both, it may need to be treated. The type of treatment depends on whether the ptosis is caused by a disease or by aging. Treating ptosis caused by aging usually involves surgery.

What happens during surgery for ptosis?

Ptosis surgery is performed under local anesthesia with sedation (the patient is awake but does not feel the procedure). The types of surgery to repair the droopy lid include the following:

• The surgeon makes an opening in the skin of the upper eyelid. This allows the surgeon to find the small muscle that raises the eyelid. The surgeon places stitches to tighten this muscle and raise the eyelid. The incision in the skin of the eyelid is then closed with more stitches.
• The surgeon can perform the entire surgery from underneath the eyelid. In this case, the eyelid is flipped and the muscle is tightened from underneath. No skin incision is required for this approach.

After surgery, the doctor will explain how to take care of the eye. It is important for the patient to come back to the doctor after surgery so the results can be checked.

Appointments are usually scheduled for several days to one week after surgery.

Sometimes, the eyelid might still droop a little bit or the eyelid might not close all the way. If the doctor notices this, additional treatment might be recommended. Usually, however, the eyelid is in a better position soon after the operation.