Droopy lids, also known as ptosis (Toe-sis) is sagging of upper eyelids giving a sleepy and tired look. It can affect one or both eyes. The degree of ptosis is sometimes barely noticeable and at times severe enough to obstruct the field of vision. 

What does one present with?

Droopy eyelids are cosmetic blemish and cause visual discomfort to a person. The eyelids lie at the lower level giving a tired, sleepy look to the face. The self esteem of a person is affected due to facial disfigurement and asymmetry. In addition droopy lids act like a curtain in front of eyes, making it difficult to read, write and drive. There is obstruction to the peripheral field of vision due to excessive hooding of the skin. Some people even complaint of headache and neck pain due to excessive use of eyebrows and tilt of head backwards to try to see under the lid.

What leads to droopy lids?

This can be divided into:

  • Natural causes- mainly related to natural ageing of the lids. With advancing age, the eyelid muscle and skin become loose and saggy leading. This can be associated with saggy brows and excessive skin over the lids. Having said that people at any age can be affected by this condition. Some children are born with droopy eyes called as congential ptosis secondary to inherent changes in the muscle development or injury to the eyelid lifting muscle during forceps delivery.
  • Medical conditions- Ptosis can also be a tell tale sign of an underlying medical condition. Some of the common diseases are: migraine, injury to the lifting muscle (after cataract surgery, trauma to lids and face), muscle disorders ( myasthenia, myopathy), mechanical pressure on the lid ( tumors, swellings), paralysis of the muscle and body stroke , brain tumor and infection of the eyelid muscles.

Are there any risk factors?

Some of the risk factors are:

  • Ageing
  • Excessive rubbing of eyes, 
  • Contact lens use
  • Family history 
  • Birth injury
  • Eye surgery such as cataract removal
  • Paralysis of nerve fibers in eyelids
  • Diabetes
  • Stroke
  • Head or eyelid trauma
  • Brain tumor

What are the myths?

Myth 1- Eye exercise and yoga can correct or delay ptosis

Ans- Eye exercises and yoga does help in toning up the muscles. But these modalities cannot halt the aging process of the the medical conditions responsible for the droopy lids

Myth 2- Lack of sleep or depression leads to droopy lids

Ans- Lack of sleep causes concentration issues, watery eyes. Depression is a psychological condition and needs to be addressed separately

Myth 3- Excessive use of computers or TV causes weak lids

Ans- TV and computer use leads to convergence weakness, eyelid and eyelash irritations and dry eyes.

Is there a treatment?

Because there are a number of reasons why an eyelid might droop, it is highly recommended that one must get an Ophthalmic Plastic surgeon to evaluate and examine eyelids. He or she will ask leading questions and may conduct medical tests. Surgical vs non surgical methods are dependent on the underlying cause. Natural conditions usually need a simple procedure to tighten and realign the lifting muscle. Medical conditions need a tailor-made approach. Special glasses called crutch glasses are used in un-operable cases to hold up the eyelid. 

Droopy eyelids are one of the most common ageing changes on the face. It is important to know that ptosis does not correct itself over time. An early visit to a specialist and prompt treatment offer promising corrective results.

Co-founded by Dr Shubhra Goel, a prominent, multiple award-winning, dually certified oculoplastic surgeon with decades of experience worldwide, Clinica Fai (www.clinicafai.com) is a super-specialist medical clinic that provides eye and face corrective treatments with particular focus on correction of dark circles, baggy/puffy eyelids &  previous treatments gone wrong. Dr Shubhra Goel has been trained under celebrity oculofacial plastic surgeon Dr Cynthia Boxrud from LA and superstar dermatologist Dr Zein Obagi from Beverly Hills.