What Is Ptosis?

Ptosis is a condition in which the upper eyelid droops over the eye. Sometimes it can interfere with your vision. The condition often affects older people but it can occur in children as well. Ptosis can occur in one eye or both eyes at the same time.

Extreme Close-Up Of Portrait Of Person With Brown Eye Details
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Symptoms of Ptosis

The most obvious sign of ptosis is drooping of the eyelid. Other symptoms include:

  • Difficulty closing the eye or blinking
  • Tearing
  • Eye fatigue
  • Trouble seeing (because of this, a person may tilt their head back in order to see under the eyelid)

Children with ptosis may have additional symptoms, such as:

  • Amblyopia, sometimes called lazy eye because one eye seems to look off in another direction
  • Nearsightedness, farsightedness, or astigmatism
  • Double, blurred, or distorted vision
  • Eye strain, headaches, or dizziness

Causes and Risk Factors

In adults, ptosis is often caused by normal aging. Aging can cause the eyelid muscles (called levator muscles) to weaken.

Sometimes people are born with ptosis. This is called congenital ptosis. Congenital ptosis may be caused by problems with the brain or nerves that lead to weakness in the eyelid muscles. Children born with a birth defect or injury that affects the eyes may also have ptosis.

People with eye tumors, diabetes, a history of stroke, cancer, and neurological disorders are at risk for developing ptosis.

Cosmetic treatment with Botox (botulinum toxin A) can sometimes cause ptosis. If you are interested in getting Botox treatments, make sure to find an experienced practitioner.

Recap

Ptosis can be caused by normal aging, eye diseases, or Botox treatments. Sometimes babies are born with ptosis.

Diagnosis

An eye doctor will diagnose ptosis by examining your eyelids closely. They will measure the height of your eyelids and the strength of the eyelid muscles.

They may also perform a computerized visual field test to see if your vision is normal. In a visual field test, you are asked to look at a series of flashing lights in a machine, without moving your eyes. When you see a light, you push a button.

Treatment

If you are an adult and are not having trouble seeing or don't mind how your eyelids look, you don't need treatment for ptosis.

The most common treatment for ptosis is a surgical procedure called a ptosis repair. The surgeon numbs the area around your eyelid with a local anesthetic. Then they make a small incision (cut) in the skin on the upper eyelid. They can then tighten the levator muscle with stitches to raise the eyelid. The incision is then closed with more stitches.

A ptosis repair may be done together with a blepharoplasty. A blepharoplasty is a surgery that removes excess eyelid skin. This extra skin can contribute to the droopiness.

Sometimes the eyebrows may be surgically lifted as well. Surgery is usually successful for people with ptosis and improves both vision and appearance.

In September 2020, the first prescription medication used to treat ptosis, called Upneeq, was approved by the Food and Drug Administration.

Upneeq (oxymetazoline hydrochloride ophthalmic solution) comes in the form of eye drops. It causes the levator muscle to contract. This allows the eyelid to open 1 to 2 millimeters wider. It is intended for adults with mild to moderate age-related ptosis. Upneeq is not approved for use in children.

Recap

Ptosis can be treated surgically with procedures called a ptosis repair or a blepharoplasty. Prescription eyedrops can also be used to treat ptosis in adults who have droopy eyelids due to aging.

Summary

Ptosis is a condition in which the eyelids droop. This can make it hard to see properly in some cases.

Ptosis is caused by a weakened muscle in the upper eyelid. It can be a result of normal aging or certain medical conditions. Sometimes, people are born with ptosis. Surgery is the most common treatment for ptosis.

A Word From Verywell

If you've noticed that your (or your child's) eyelids seem to be drooping, contact your doctor, especially if you are having difficulty seeing normally. They can refer you to an eye doctor, who can confirm whether you have ptosis.

Frequently Asked Questions

  • What is the eye levator muscle?

    The eye levator muscle (levator palpebrae superioris) is located in each upper eyelid. It allows the eyelids to be raised and maintained. When this muscle is weakened due to aging or otherwise, it can result in blepharoptosis (ptosis), which causes one or both drooping eyelids.

  • Is there ptosis treatment without surgery?

    Yes, ptosis treatment without surgery comes in the form of prescription eye drops. These are usually reserved for mild ptosis since more severe cases may call for surgery. Alternatively, by applying the back of a running electric toothbrush to the eyelid for a few minutes each day, some doctors have been able to strengthen the eyelid levator muscle. This method may not be an effective treatment for severe ptosis.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Ophthalmology. What is ptosis?

  2. Nemours Foundation. KidsHealth. Ptosis.

  3. American Academy of Ophthalmology. What is lazy eye?

  4. Finsterer J. Ptosis: Causes, presentation, and managementAesth Plast Surg. 2003;27:193–204. doi:10.1007/s00266-003-0127-5

  5. King M. Management of ptosis. J Clin Aesthet Dermatol.

  6. American Academy of Ophthalmology. Upper eyelid blepharoplasty.

  7. American Academy of Ophthalmology. First prescription fix for droopy eyelids.

  8. Knight B, Lopez MJ, Patel BC. Anatomy, Head and Neck, Eye Levator Palpebrae Superioris Muscles. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.

By Troy Bedinghaus, OD
Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.