“Ptosis” is the medical term for a drooping upper eyelid. Eyelid
drooping can sometimes affect your vision if it’s severe. Ptosis isn’t a
disease. It’s actually a symptom of a condition that you should seek treatment
What Causes Ptosis?
A number of factors that affect the muscles, nerves, or skin
of the eyelids can cause ptosis. The muscles that allow your eyelids to move up
and down are called the levator muscles. They can weaken from age or injury. In
addition, some people may be born with eye muscles that are weaker than normal,
causing them to develop ptosis at a young age.
Nerve damage can contribute to ptosis as well. A common
cause of ptosis is Horner’s syndrome. Horner’s syndrome is a form of nerve
damage that occurs in the face and eyes. It’s usually the result of an
underlying condition. Stroke and other brain injuries, spinal cord injuries,
and some forms of lung cancer can cause Horner’s syndrome and ptosis.
Some chronic conditions, including diabetes and myasthenia
gravis, may also increase your risk of ptosis. Diabetes is an inability to
process sugar correctly. It can lead to a number of complications, including
eye disease. Myasthenia gravis is an autoimmune disease that affects the way
your muscles and nerves communicate.
Cluster headaches can also cause ptosis in some people.
Cluster headaches are severe headaches that strike frequently during “cluster
periods” and then go into remission.
What Are the Symptoms of Ptosis?
The primary symptom of ptosis is a visible drooping of the
upper eyelid. Ptosis can affect children and adults at any stage of life. You
may notice symptoms in one or both eyes. People who are born with drooping
eyelids have congenital ptosis. One of the signs of congenital ptosis is having
uneven or absent creases in the eyelids.
Children who have ptosis may use certain gestures or body
positions common to people with this symptom. Frequent eyebrow raising and head
tilting can indicate that ptosis is interfering with normal sight.
How Is Ptosis Diagnosed?
The American Academy
of Ophthalmology stresses the importance of eye exams for children and
adults with ptosis. A vision test that uses an eye chart can help determine if
eyelid drooping is compromising your or your child’s vision.
Blood tests used to detect diabetes and autoimmune
conditions can help diagnose the underlying cause of ptosis. Your doctor may
also perform X-rays to see if structural abnormalities around the eye are
causing the problem.
What Are the Treatment Options for Ptosis?
Treatment for ptosis varies. If diabetes is the cause, your
doctor will teach you how to manage this condition. Drooping eyelids caused by any
of the following may resolve after your doctor addresses the underlying
Treatment for Ptosis Caused by Myasthenia Gravis
If myasthenia gravis is the cause, you doctor will likely
prescribe medication to ease ptosis and other symptoms of this disease. Medications,
such as neostigmine and pyridostigmine, may help your muscles and nerves work
together more effectively. Your doctor may also prescribe prednisone or other
Treatment for Congenital Ptosis
In cases of congenital ptosis, the levator muscles usually
don’t improve on their own. They may require surgery. Surgical repair involves
manually tightening the levator muscles to lift the eyelid. You may have
trouble opening and closing your eye immediately after surgery, but as you recover,
this function will return. An eyelid lift can restore normal vision in many
Children who have ptosis are at an increased risk for
developing a lazy eye. Lazy eye, called amblyopia, is the blurring or absence
of vision in one eye. Amblyopia occurs when you have impaired nerve connections
between your brain and eye.
One treatment for this condition involves putting a patch
over your normal eye to make your lazy eye work more efficiently. Surgical
repair of ptosis can help prevent lazy eye.
What Is the Long-Term Outlook?
The underlying cause of ptosis plays a major role in
determining the outlook for people with this condition. Surgery can be very successful
in restoring vision, eye function, and the appearance of the eye.
The American Academy
of Ophthalmology reports that making a small tuck in the lifting muscle and
removing excess skin can make a big difference in appearance. In more severe
cases, the levator muscle may need strengthening and reattachment. In some
cases, however, even after surgery your eyelids may not look entirely
Surgery carries the risk of:
abnormal lid crease
of the eyelid to close completely
Therefore, surgery is indicated only in cases of disabling