Droopy Eyelids – Ptosis

Ptosis is the drooping of the upper eyelid, which can affect vision, appearance and eyelid function. Learn the symptoms, causes, diagnosis and when treatment is required.

What Is Ptosis?

Ptosis (pronounced toe-sis) refers to a drooping upper eyelid that sits lower than normal. It can affect one eye or both and range from mild to severe.
When the lid droops enough to cover part of the pupil, it can significantly reduce the upper field of vision and cause functional problems such as eye strain, headaches and difficulty reading.

Ptosis may be present at birth (congenital ptosis) or develop later in life (acquired ptosis).
Adult ptosis is most commonly caused by weakened or stretched eyelid muscles, particularly the levator muscle, which lifts the upper lid.

Symptoms of Ptosis

Symptoms vary depending on severity.

Common signs include:

  • Drooping upper eyelid

  • Reduced upper visual field

  • Difficulty keeping the eyes open

  • Eye strain or forehead tension from lifting brows

  • Asymmetrical eyelid appearance

  • Needing to tilt the head back to see

  • Fatigue when reading

  • Children: chin-up posture or delayed vision development

In some cases, ptosis may worsen throughout the day as the muscles tire.

Causes and Risk Factors for Ptosis

Ptosis develops when the eyelid lifting muscles weaken, loosen or fail.

Main causes include:

1. Aponeurotic Ptosis (Most Common)

Age-related stretching or thinning of the levator tendon.

2. Congenital Ptosis

Poor development of the levator muscle from birth.

3. Neurological Causes

  • Third nerve palsy

  • Horner syndrome

  • Myasthenia gravis

These require medical evaluation.

4. Mechanical Ptosis

Caused by:

  • Heavy eyelid skin

  • Eyelid lumps

  • Previous surgery

  • Contact lens overwear (especially hard lenses)

5. Trauma

Direct injury to the eyelid or surrounding structures.

6. Post-Surgical

Can follow:

  • Cataract surgery

  • Glaucoma surgery

  • Blepharoplasty or previous ptosis repair

Age, genetics and prolonged eyelid rubbing also increase risk.

Diagnosis and Assessment

Assessment includes:

  • Eyelid height measurements (MRD1, levator function)

  • Evaluation of brow position and eyelid symmetry

  • Exclusion of neurological causes

  • Assessment of visual field obstruction

  • Eyelid photography

  • Consideration of skin redundancy

  • In children: assessing impact on visual development

Diagnosis determines whether surgical correction is functional or cosmetic.

When to Seek Advice

Book an assessment if you notice:

  • Increasing drooping of one or both lids

  • Reduced vision from eyelid covering the pupil

  • Forehead strain or brow fatigue

  • Difficulty reading or driving

  • A child with a drooping eyelid

  • A sudden onset drooping lid (requires urgent evaluation)

Early assessment prevents visual strain and, in children, long-term visual impairment.

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Treatment Options

Lower Eyelid Correction

Lower eyelid correction surgery restores proper eyelid position in ectropion and entropion, reducing irritation, watering and risk of corneal damage.

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Blepharoplasty (Eyelid Surgery)

Blepharoplasty at the Eye Doctor Clinic is consultant led eyelid surgery to correct heavy or drooping eyelids, improve vision, and refresh appearance safely with natural results.

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Eye Bag Removal Surgery

Eye bag removal surgery smooths and rejuvenates the under-eye area by removing or repositioning fat and tightening the lower eyelid, restoring a refreshed and natural appearance.

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Ptosis Surgery

Ptosis surgery lifts a drooping upper eyelid to improve vision, comfort and symmetry. It restores normal eyelid function and offers long-lasting cosmetic and functional benefits.

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Eyelid Cyst Removal Surgery

Eyelid cyst removal surgery is a quick, effective procedure used to treat persistent or bothersome eyelid lumps such as chalazia and sebaceous cysts. It offers fast relief with minimal downtime and excellent cosmetic results.

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Macula Hole / VMT Surgery

Macula Hole / VMT Surgery is a precise retinal procedure that removes traction, closes macula holes, and restores central vision. With modern micro-incision techniques, the procedure offers excellent success rates and significant visual improvement for most patients.

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Ptosis - Droopy Eyelids