Eyelid drooping

Eyelid drooping is excess sagging of the upper eylid. 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 chronic disease in which the body cannot regulate the amount of sugar in the blood.

  

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• Horner syndrome

  Horner syndrome

  Horner syndrome is a rare condition that affects the nerves to the eye and face.

  

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• Myasthenia gravis  

  Myasthenia gravis

  Myasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them.

  

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• 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...

  

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• Swelling in the eyelid, such as with a stye

Symptoms

Drooping of one or both eyelids is present. The lid may cover only the upper eye, or the entire pupil will be covered.

Problems with vision will also 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, the upper part of vision becomes 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 draining from the eyes. Tears help keep the surface of the eye moist. They wash away particles and foreig...

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Exams 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.

A physical exam will be done to determine the cause.

Tests 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.

  

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• Tension 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...

  

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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...

  

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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