Ptosis and Drooping Eyelids

What is ptosis?

Ptosis is the medical name for drooping of the upper lid, which can be present in one or both eyes. A low lying upper lid can interfere with the top part of the visual field and may also be a cosmetic problem. Patients might have trouble keeping their eyelids open, or experience eyestrain or eyebrow ache from increased effort needed to raise the eyelids. Ptosis can either be present at birth (congenital), or may present later in life (acquired). Ptosis occurring as an adult can be from long-term contact lens wear, trauma, after cataract surgery or other eye operations. There are less common causes of a droopy eyelid, such as problems with the nerves or muscles.

How is ptosis treated?

Ptosis surgery usually involves re-attaching or shortening the muscles or tendon that raise the lid. This is done using sutures, which are buried under the skin. The skin incision is made in the existing eyelid crease (skin fold) and sutures may be visible immediately after the operation. However, these will be removed at around one week after surgery. Occasionally the lid is suspended from the brow in order to raise it.

The operation takes about 45-60 minutes per eye as a day case procedure, with no need for an overnight stay in hospital. If both eyes have ptosis it is usually best to operate on both sides at the same time to give the best chance of a symmetrical result. It is usually done with the patient awake with the use of numbing local anesthetic injections and sedation medications. This minimises any discomfort but allows for judgement of the lid position during surgery by asking you to open and close your eyelids from time to time.