Eyelid drooping

Causes

A drooping eyelid is most often due to:

• Weakness of the muscle that raises the eyelid
• Damage to the nerves that control that muscle
• Looseness of the skin of the upper eyelids

Drooping eyelid can be:

• Caused by the normal aging process
• Present before birth
• The result of an injury or disease

Diseases or illnesses that may lead to eyelid drooping include:

• Brain tumor or other cancer, which can affect nerve or muscle reactions
• Diabetes
• Horner syndrome
• Myasthenia gravis 
• Stroke

Symptoms

• Drooping of one or both eyelids
• Increased tearing
• Interference with vision (if the drooping is severe)

Exams and Tests

A physical examination will be done to determine the cause.

Tests that may be performed include:

• Slit-lamp examination
• Tension test for myasthenia gravis
• Visual field testing

Treatment

If a disease is found, it will be treated. Most cases of drooping eyelids are due to aging and there is no disease involved.

Eyelid lift surgery (blepharoplasty) is done to repair sagging or drooping upper eyelids.

• In milder cases, it can be done to improve the appearance of the eyelids. 
• In more severe cases, surgery may be needed to correct interference with vision.
• In children with ptosis, surgery may be needed to prevent amblyopia, also called "lazy eye."

Outlook (Prognosis)

The expected outcome depends on the cause of the ptosis. Surgery is usually very successful in restoring appearance and function.

When to Contact a Medical Professional

Get a referral to an ophthalmologist, a medical doctor who is trained to diagnose and treat eye problems, for:

• Drooping eyelids in children
• New or rapidly changing eyelid drooping in adults

Alternative Names

Ptosis

References

Custer PL. Blepharoptosis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier; 2008:chap 12.5.

Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 431.

Update Date: 8/14/2012

Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.