Drooping eyelids, also called ptosis, is an annoying condition that can affect one or both lids.  The lids may sag so much they block the line of sight. Some people get a headache from the effort to hold their lids open wider.  A levator muscle holds the upper eyelid in proper position and moves it up and down.  Any condition that affects this muscle will also affect the lid position.

Most cases of ptosis in an adult come on gradually during the later years of life, as part of the normal aging process.  The levator muscle stretches, thins, or loosens its attachment to the eyelid, causing it to sag.  Less common causes include injury, previous eye surgery, and neurological and muscle problems. Or the levator muscle or its nerve supply can be involved in diabetes or myathenia gravis.  Occasionally a drooping lid in an adult has actually been present since birth (congenital) but has never been treated. A thorough evaluation by an ophthalmologist can differentiate between these different conditions and treatment can be initiated on an individual basis.

If myathenia gravis is the cause of drooping eyelids, taking pills will improve the eyelid function.  If it is associated with diabetes, it generally improves over time.  Surgery may be needed to correct the age-related drooping eyelids if it starts to affect vision.  A visual field test can be done in our office to assess the visual field deficit before surgery.  Surgery generally have good result both functionally and cosmetically. Sometimes the operated eyelid does not close well for a few weeks after the surgery, but this condition usually corrects itself without further surgery.   The surgical incision is usually unnoticeable because it is hidden in a natural eyelid crease or on the underside of the upper lid.  Most patients are delighted with their improved appearance and their clear, unobstructed vision.