Eyelid drooping
Ptosis, Dermatochalasis; Blepharoptosis; Third nerve palsy - ptosis; Baggy eyelidsEyelid drooping is excess sagging of the upper eyelid. The edge of the upper eyelid may be lower than it should be (ptosis) or there may be excess baggy skin in the upper eyelid (dermatochalasis). Eyelid drooping is often a combination of both conditions.
The problem is also called ptosis.
Causes
A drooping eyelid is most often due to:
- Weakness of the muscle that raises the eyelid
- Damage to the nerves that control that muscle
- Looseness of the skin of the upper eyelids
Drooping eyelid can be:
- Caused by the normal aging process
- Present before birth
- The result of an injury or disease
Diseases or illnesses that may lead to eyelid drooping include:
- Tumor around or behind the eye
- Diabetes
Diabetes
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.
Read Article Now Book Mark Article - Horner syndrome
Horner syndrome
Horner syndrome is a rare condition that affects the nerves to the eyes and face.
Read Article Now Book Mark Article - Myasthenia gravis
Myasthenia gravis
Myasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them.
Read Article Now Book Mark Article - Stroke
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
Read Article Now Book Mark Article - Swelling in the eyelid, such as with a stye
Symptoms
Drooping may be present in one or both eyelids depending on the cause. The lid may cover only the upper eye, or the entire pupil may be covered.
Problems with vision will often be present:
- At first, just a sense that the very upper field of vision is being blocked.
- When the drooping eyelid covers the pupil of the eye, vision may become completely blocked.
- Children may tip their head back to help them see under the eyelid.
- Tiredness and achiness around the eyes may also be present.
Increased tearing despite a feeling of dry eyes may be noticed.
Increased tearing
Watery eyes means you have too many tears in and draining from the eyes. Tears help keep the surface of the eye moist. They wash away particles and...
Read Article Now Book Mark ArticleExams and Tests
When drooping is on one side only, it is easy to detect by comparing the two eyelids. Drooping is more difficult to detect when it occurs on both sides, or if there is only a slight problem. Comparing the current extent of drooping with the amount shown in old photos may help you detect the progression of the problem.
A physical exam will be done to determine the cause.
Physical exam
During a physical examination, a health care provider checks your body to determine if you do or do not have a physical problem. A physical examinati...
Read Article Now Book Mark ArticleTests that may be performed include:
- Slit-lamp examination
Slit-lamp examination
The slit-lamp examination looks at structures that are at the front of the eye.
Read Article Now Book Mark Article - Tensilon test for myasthenia gravis
- Visual field testing
Visual field testing
The visual field refers to the total area in which objects can be seen in the side (peripheral) vision as you focus your eyes on a central point. Thi...
Read Article Now Book Mark Article
Treatment
If a disease is found, it will be treated. Most cases of drooping eyelids are due to aging and there is no disease involved.
Eyelid lift surgery (blepharoplasty) is done to repair sagging or drooping upper eyelids.
- In milder cases, it can be done to improve the appearance of the eyelids.
- In more severe cases, surgery may be needed to correct interference with vision.
- In children with ptosis, surgery may be needed to prevent amblyopia, also called "lazy eye."
Amblyopia
Amblyopia is the loss of the ability to see clearly through one eye. It is also called "lazy eye. " It is the most common cause of vision problems i...
Read Article Now Book Mark Article
Outlook (Prognosis)
A drooping eyelid can stay constant, worsen over time (be progressive), or come and go (be intermittent).
The expected outcome depends on the cause of the ptosis. In most cases, surgery is very successful in restoring appearance and function.
In children, more severe drooping eyelids may lead to lazy eye or amblyopia. This may result in long-term vision loss.
When to Contact a Medical Professional
Contact your health care provider if:
- Eyelid drooping is affecting your appearance or vision.
- One eyelid suddenly droops or closes.
- It is associated with other symptoms, such as double vision or pain.
See an eye specialist (ophthalmologist) for:
- Drooping eyelids in children
- New or rapidly changing eyelid drooping in adults
References
Alghoul M. Blepharoplasty: anatomy, planning, techniques, and safety. Aesthet Surg J. 2019;39(1):10-28. PMID: 29474509 pubmed.ncbi.nlm.nih.gov/29474509/.
Cioffi GA, Liebmann JM. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 395.
Friedman O, Zaldivar RA, Wang TD. Blepharoplasty. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 26.
Olitsky SE, Marsh JD. Abnormalities of the lids. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 642.
Vargason CW, Nerad JA. Blepharoptosis. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 12.4.
Ptosis - drooping of the eyelid - illustration
Drooping of the eyelid is called ptosis. Ptosis may result from damage to the nerve that controls the muscles of the eyelid, problems with the muscle strength (as in myasthenia gravis), or from swelling of the lid.
Ptosis - drooping of the eyelid
illustration
Ptosis - drooping of the eyelid - illustration
Drooping of the eyelid is called ptosis. Ptosis may result from damage to the nerve that controls the muscles of the eyelid, problems with the muscle strength (as in myasthenia gravis), or from swelling of the lid.
Ptosis - drooping of the eyelid
illustration
Review Date: 8/22/2022
Reviewed By: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.