Ptosis, also known as “droopy eyelid,” is a relatively common condition that can affect one or both eyes, leading to a noticeable drooping of the upper eyelid. Children may be born with ptosis or it can be acquired later in life.
While it can be a cosmetic concern for many, it’s also important to understand that ptosis can sometimes signal underlying health issues or impact vision. In this blog, we’ll walk you through the basics of ptosis, how to identify it, and what treatment options are available.
What Exactly is Ptosis?
Ptosis occurs when the muscles responsible for lifting the upper eyelid—the levator and Müller’s muscles—become weak or stretched, causing the lid to sag lower than normal. The condition can affect people of all ages, from infants to the elderly, although it’s more commonly seen in adults as part of the natural aging process.
There are several types of ptosis, including:
- Congenital ptosis: This is present at birth and typically due to underdeveloped levator muscles *or congenital facial abnormalities.
- Acquired (or involuntary) ptosis: Occurs later in life and can result from aging, injury, or certain neurological or muscular disorders.
How to Spot Ptosis
Ptosis isn’t always dramatic, but even a subtle drooping of the eyelid can be noticeable. Here are some signs to look out for:
- A visibly lower eyelid: This is the most obvious sign of ptosis. One or both eyelids may appear to be drooping.
- Upper eyelid creases that do not line up evenly with each other
- Difficulty keeping the eyes open: Some people with ptosis find it challenging to keep their eyes fully open, causing them to raise their eyebrows or tilt their head to see better. Aching eyebrows or headaches are frequently reported symptoms.
- Blocked or impaired vision: In more severe cases, ptosis can obstruct part of the visual field, making everyday tasks like reading or driving difficult.
- Eye fatigue or strain: Since the muscles have to work harder to keep the eyelids open, those with ptosis may experience tired or strained eyes.
- Children who are born with or develop ptosis can also have other eye related problems or go on to develop other eye problems because of ptosis such as astigmatism or amblyopia (a lazy eye) so it is important that any child with ptosis should see an Ophthalmologist.
Many cases of ptosis can be diagnosed at home by comparing current and previous or old photographs. In other cases, an eye professional will be needed to make the diagnosis. If you notice any of these symptoms, it’s a good idea to book an appointment with an eye specialist for a thorough examination.
Ptosis can be harmless in most cases, however in rare cases the following symptoms require immediate medical attention;
- Sudden onset ptosis that develops over hours or a few days.
- Ptosis that develops with double vision, slurred speech or muscle weakness.
- Ptosis accompanied by signs of infection in the eye, loss of vision or bulging of the eye
What Causes Ptosis?
Ptosis can be caused by a number of factors, including:
- Congenital factors: In some cases, children are born with weak or improperly developed eyelid muscles.
- Age-related muscle weakening: As we age, the muscles that lift the eyelid can stretch or weaken, making it more difficult to keep the eyelid in its natural position.
- Injury or trauma: Physical damage to the eyelid or surrounding muscles can result in ptosis.
- Neurological conditions: Certain disorders, such as myasthenia gravis or Horner’s syndrome, can affect the nerves controlling the eyelid muscles.
- Previous eye surgery: Procedures like cataract surgery can sometimes lead to the development of ptosis.
Treating Ptosis: What Are Your Options?
The good news is that ptosis can often be treated effectively, with options ranging from non-surgical approaches to surgery. The appropriate treatment will depend on the severity of the ptosis and its underlying cause.
Treatment for Underlying Conditions
If ptosis is caused by a neurological or muscular disorder, addressing the underlying condition is essential. In these cases, treatment might include medications or other therapies to manage the disorder, which could, in turn, improve ptosis.
Observation
If the ptosis is mild and not affecting vision, your eye specialist may recommend monitoring the condition. In cases where the drooping is age-related and doesn’t interfere with daily life, treatment may not be necessary.
Oxymetazoline is a prescription eye drop for the treatment of certain types of adult ptosis. It causes the muscles that lift the lid to contract, opening the eye by 1-2mm. It must be used daily.
Ptosis Crutch or ptosis props
For individuals who are not suitable candidates for surgery, a non-invasive option known as a ‘ptosis crutch or ptosis prop’ can be fitted onto glasses. This small device helps lift the eyelid, providing relief from drooping and improving vision.
Contact lenses
Specialised contact lenses can occasionally be used to help support the eyelids
Eyelid Surgery
For those with moderate to severe ptosis, or if the drooping eyelid is affecting vision, surgery is often recommended.
Surgery involves tightening the muscles that lift the eyelid and surgically raising the eyelid or eyelids. The procedure is typically straightforward, and recovery time is usually quick.
These procedures are performed through small incisions, typically hidden in the upper eyelid skin crease.
Eyelid surgery may be combined with other procedures. This can include blepharoplasty, an operation to remove excess skin from the eyelid or a brow lift procedure.
Anaesthesia for ptosis surgery in adults is usually local meaning that patients are comfortable but awake. Children undergo surgery under general anaesthesia.
When to Seek Medical Advice
If you or a loved one are experiencing ptosis, particularly if it’s accompanied by symptoms like vision loss, double vision, or muscle weakness in other parts of the body, it’s essential to seek medical advice promptly.
A thorough eye exam can help identify the cause and determine the best course of action.
At Anderson Eye Care, we understand that ptosis can be both a cosmetic concern and a functional one. Our experienced team is here to advise and guide you through the most suitable treatment options.
Whether it’s a surgical solution or a more conservative approach, we’ll ensure your care is tailored to your individual needs.
Conclusion
Ptosis may seem like a minor inconvenience at first, but left untreated, it can have a significant impact on your quality of life. Identifying the condition early and understanding your treatment options can help you maintain both your eye health and your vision.
If you’re concerned about ptosis or any other eyelid condition, feel free to get in touch with us at Anderson Eye Care. We’re here to help you see the world with clarity and confidence.
Medical Disclaimer
This article is for information purposes only and should not be considered medical advice. If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that you have read on this blog, website or in any linked materials.
