Droopy Eyelids

Droopy eyelids, medically known as ptosis, is a condition in which the upper eyelid droops. It can affect one or both eyelids. The eyelids may sag a little or cover just the pupil or completely cover the eye, blocking your vision. In some cases, a droopy eyelid/ptosis can be present after birth or may appear later in life due to disease or injury.

The main symptom of droopy eyes is that the eyelid may cover the upper eye or the entire pupil and occur in one or both eyes.

The other symptoms that you might notice due to droopy eyes are:

1. Blocked upper field of vision
2. Blocked complete vision as the eyelid covers the pupil of the eye
3. Pain and tired look around the eye
4. Tilting the head back (chin-up position) to see properly (in children)
5. Watery eyes
6. Raised eyebrow in order to lift the lid
7. Headache, eye strain, or dizziness
8. Far-sightedness, near-sightedness, or astigmatism (a lens or an eye defect)

Droopy eyelids can occur due to:

1. Damage to the nerves or muscles that control the eyelid 
2. Skin looseness of the upper eyelid
3. Weakness in eyelid muscles
4. Aging process
5. Tumour behind or around the eye
6. Myasthenia gravis: a disease-causing abnormal and excessive muscle weakness
7. Horner’s syndrome: damaged nerve on the side of the neck causing a droopy eyelid
8. Diabetes
9. Eyelid swelling such as stye: inflamed swelling on the edge of the eyelid
10. Stroke

Risk factors of droopy eyelids include:

1. Aging
2. Injury 
3. Disease or illness (myasthenia gravis, stroke, Horner’s syndrome)

Your ophthalmologist will:

1. Review all the symptoms
2. Ask about your medical history
3. Ask about your family history for droopy eyelids or other muscular disorders
4. Conduct a complete examination of your eye
5. Prescribe imaging tests such as magnetic resonance imaging (MRI) or computed tomography (CT) scan and blood tests
6. Other tests will be done, such as tensilon test for myasthenia gravis, slit-lamp examination (your doctor uses a microscope that has a bright light to get a complete and closer look at your eye), and visual field testing (measure how far away you can see in any direction without moving)

Your ophthalmologist will suggest you treatment of droopy eyes depending on the cause and the severity of ptosis. Depending on the cause and the severity your doctor may:

1. Suggest ptosis surgery (blepharoplasty) to repair the droopy eyelid. In this surgery, your doctor will inject local anaesthesia and make a cut in the eyelid to find the muscles that lift the eyelid. They tighten the muscle by stitching it and further, seal the cut with additional stitches.
2. Use a patch over the unaffected eye. The use of a patch over the stronger eye strengthens the weaker eye. 
3. Put on some eye drops or special glasses. In some cases, they would give you an eyeglass-like frame (ptosis crutch) to support your eyelid.

If not treated in time, the droopy eyelid can lead to:

1. Amblyopia
2. Loss of vision
3. Abnormal head position may cause neck and head deformity

You must consult your ophthalmologist if:

1. One eyelid suddenly shuts or droops
2. Ptosis affects your vision or appearance
3. Ptosis is linked with pain or double vision