Ptosis (drooping eyelid)

The upper eyelid is lifted by a muscle and its tendon. When this tendon stretches or the muscle weakens, the eyelid droops. Ptosis may be mild and only cosmetic, or cover part of the pupil and reduce the upper field of vision. To compensate, many people raise their eyebrows or tilt their head back, which is tiring and causes headaches.

SEEN FROM THE FRONT

Eyelid position

In ptosis, the eyelid can end up covering the pupil.

1

Normal position

The eyelid edge covers only 1 to 2 mm of the top of the iris.

2

Ptosis

The eyelid drops and reduces the upper field of vision; it may cover the pupil.

What are the causes?

• Ageing: the most common cause in adults.
• Long-term rigid contact lens wear, previous eye surgery and injuries.
• Congenital: present from birth. If it covers the pupil, it can cause amblyopia and should be assessed early.
• Nerve or muscle diseases, such as myasthenia, in which ptosis varies through the day and worsens with fatigue.

A ptosis that appears suddenly, especially with double vision, headache, eye pain or pupils of different sizes, may indicate a neurological problem and needs urgent assessment.

How is it corrected?

Once the cause is clear, correction is surgical: the muscle tendon is repositioned or shortened to lift the eyelid. It is usually done under local anaesthesia as day surgery. Ptosis often coexists with excess eyelid skin (dermatochalasis), which can be corrected in the same operation. In the first days there is swelling and bruising, and lubricants may be needed, as the eyelid may not close fully for a while.

This information does not replace an individual medical assessment. Follow the advice of the team looking after you.