Ptosis (droopy eyelid)

What is ptosis?

If you have droopy or sagging eyelids, you may have ptosis, or ptosis of the eyelid. It’s possible to have one droopy eyelid (unilateral ptosis) or both (bilateral ptosis).

Congenital ptosis

Sometimes children are born with ptosis. This is called congenital ptosis. It’s often caused by the muscle that lifts the upper eyelid not having developed properly.

If your child has congenital ptosis, you might notice that one or both of their eyelids are drooping. Also, if they tilt their head back or raise their eyebrows to help them see better, this could be a sign of ptosis. If they are constantly tilting their head back to help them see, this can lead to problems with their head and neck.

Ptosis in children can lead to other vision problems. If one of their eyelids droops far enough to block their vision, they may develop amblyopia. This is where the vision in one of their eyes is better than in the other. They can also develop astigmatism or crossed eyes.

Children born with ptosis may have other eye problems, like tumours on the eyelid or difficulty with moving their eyes.

How serious is ptosis?

Most of the time, ptosis is caused by an issue with the eye muscles themselves. Either the muscle that lifts your eyelid becomes weak or stretched, or it becomes detached. This kind of ptosis is generally not serious, although it’s still a good idea to seek treatment for it. It can still affect your vision or cause neck strain, as you may bend your neck to see out from under your eyelids.

However, it’s possible for ptosis to be a symptom of a more serious problem, such as a brain tumour or a stroke.⁵ If you have a sudden droopy eyelid which has developed over a few days or even a few hours⁵, then it’s more likely to be a symptom of a serious problem. If this is the case, you should talk to your doctor urgently as it could be a medical emergency. By contrast, ptosis caused by weakening muscles usually takes months or even years. Ordinary muscle weakness tends to get worse over the course of the day, as you become more tired, whereas a droopy eyelid that’s a symptom of a more serious problem may happen at random times of the day and even switch from one eye to the other.

Ptosis treatment

There are a few different options for droopy eyelid treatment, including medication and surgery.

If you have a baby or young child with congenital ptosis, it’s a good idea to get it treated as soon as possible, so it doesn’t affect the development of their vision.

If your child has developed amblyopia (one eye that doesn’t see as well as the other eye) as a result of ptosis in one eye, this will need to be treated as well. This usually involves wearing a patch or special glasses to cover the stronger eye so that the weaker eye can be strengthened.

In ptosis surgery, the surgeon might make a small adjustment to the muscle that lifts your eyelid, or they might need to reattach it to your eyelid if it’s become separated. You will probably be able to have the surgery under local anaesthetic.