Eye Care Instructions for a Drooping Eyelid (Ptosis)

What is ptosis?

Ptosis (say toe-sis) is a drooping of the upper eyelid. If you have ptosis, your eyelid does not lift up enough to uncover your eye completely. Drooping of your eyelid may be mild and barely noticeable, or it may be so severe that the eyelid covers the pupil of your eye, making it hard for you to see.

Ptosis may involve one or both eyes. It is usually not painful, but if it is severe or left untreated, it may cause other eye conditions. Ptosis can occur in children or adults.

What causes ptosis?

  • Ptosis may be caused by normal aging, an eye injury, or eye disease.
    • As you age, the muscles that hold up your eyelid may retract, causing your eyelid to droop.
    • Ptosis may be caused by complications from eye surgery or an injury that damages eyelid muscles or nerves that control eyelid muscles.
    • Medical conditions such as diabetes, stroke, certain cancers (including brain tumor), or diseases that cause muscle weakness or nerve damage may lead to ptosis.
  • Some children are born with ptosis. When this happens, it is called congenital ptosis.

What are the signs of ptosis?

  • Ptosis may cause
    • Drooping of the eyelids
    • Trouble closing the eye or blinking
    • Tears to form in the eye
    • Eye fatigue from straining to keep the eye open
    • Double vision
  • A child with ptosis may tilt his or her head back to lift the eyelid to see. Children should be evaluated early to prevent the possibility of developing a “lazy eye”.
  • Ptosis can interfere with blinking, which may lead to irritation, infection, or eyestrain.

What should I expect after surgery for ptosis?

  • It may take a short time for your eye to close all the way after surgery. Eyedrops or ointments that wet your eye may help during this period.
  • After surgery, your eyelids may not look perfectly level. Sometimes additional surgery is needed to completely correct ptosis.

When would I need to go to the ER?

If you experience diplopia (cross eyes) with monocular ptosis, you should go to an emergency room. This can be sudden and asymmetric, or only one side and may indicate a medical emergency.