Ptosis (Droopy Eyelids) Treatment & Cure

What is ptosis?

Ptosis is defined as abnormal drooping of either right and/or left upper eyelid that usually occurs from a partial or complete dysfunction of the muscles that elevate the upper eyelid – the levator palpebrae and the Müller’s muscle. Ptosis, or pathologic droopy eyelid, can occur as a result of eye trauma, age, or in conjunction with various medical disorders.

Congenital ptosis is the presence of droopy eyelids at birth which can be inherited. Acquired ptosis is when the condition develops later in life. However, the disturbance in vision, depends on the amount of obstruction to the pupil by the eyelid. It is important to see an eye doctor to determine if your case will resolve through medical intervention or naturally.

Is droopy eyelid common?

Droopy eyelids are most commonly found in older adults. As you age, the levator muscle responsible for lifting the eyelid will naturally stretch out and cause the eyelid to droop.

Neurological disorders and trauma can also be related to droopy eyelids, so be sure to let us know of any recent trauma or pre-existing conditions during your appointment.

Ptosis is not typically a cause for concern, but the doctors at Boerne Vision Center can access your eyelids and help create a plan to help with your condition.


Congenital ptosis is primarily caused by a delay in the development of the levator muscle. Amblyopia, more commonly known as lazy eye, can develop in children who have ptosis. Lazy eye can also delay or limit their vision development and even lead to permanent decreased vision if not addressed. Please let us know if you or your child has had a history of congenital ptosis or lazy eye.

What are the risk factors for droopy eyelid?

Medical conditions

There are some medical concerns we will discuss with you when we meet to consult about your concerns related to droopy eyelids. If your eyelids are drooping, it could be a sign of an underlying medical condition, especially if the issue affects both eyelids.

If only one of your eyes are affected by droopy eyelids, it may be a result of a nerve injury, a stye, or other eye concern. Routine LASIK, cataract surgery, or surgery around the face or eyes can lead to a development of ptosis, as a result of the muscle or tendon being stretched or damaged, so please let us know if you have had any recent surgeries or treatments.

Serious conditions

In some cases, droopy eyelid is caused by more serious conditions, such as a stroke, brain tumor, or cancer of the nerves or muscles. Neurological disorders that affect the nerves or muscles of the eyes — such as myasthenia gravis — can also lead to ptosis. Boerne Vision Center can work with your team of doctors as well as perform tests to see if the ptosis is related to any vision loss possibly associated with serious conditions. We can also monitor for progression or improvement of your ptosis and vision.

What are the symptoms of droopy eyelid?

The main symptom of droopy eyelids is that one or both upper eyelids sag. In some cases, this can affect your vision. You may find that the eyelid sagging is barely noticeable or does not happen all the time.

If you have extremely dry or watery eyes, you may notice that your face looks weary or tired. We can co-manage a range of eyelid treatment options from topical eye drops to surgeries with oculoplastic surgeons and pride ourselves on being a part of your team to help resolve your drooping eyelids.

You may also experience aching or tired brows as a result of ptosis so be sure to let us know of any discomfort you are facing. Some people with severe ptosis may have to tilt their heads back in order to see at all times when speaking, even when holding a normal conversation.

Boerne Vision Center will investigate persistent droopy eyelids to make sure there are no underlying conditions. This is especially important if you notice that migraine headaches or other issues have shown up since you first noticed the drooping. We can consult with you on the best ways to resolve your vision problems related to your drooping eyelids.

How is droopy eyelid diagnosed?

The Boerne Vision Center team will perform a comprehensive eye exam and ask you about your medical history. Once we understand how often your eyelids droop and the length of time this has been happening, we will run some tests to find the cause. One of the tests we will perform is a slit lamp exam so we can take a close look at your eye with the help of light and microscopes. Another exam that can be used to assess the droopy eyelid is the visual field test. We may also take photos of your eyelids.

How is droopy eyelid treated?

If your eyelid blocks your vision, you will need medical treatment. Topical prescription treatment for acquired blepharoptosis includes Upneeq, an ophthalmic formulation of oxymetazoline, which when administered to the eye is believed to selectively target Müller’s muscle and elevate the upper eyelid. However, you may opt for oculoplastic surgery if you want to reduce the drooping permanently. We co-manage eyelid surgery with a network of specialists. We will also work with you and your primary care provider to discover the best treatment plan if your droopy eyelid is caused by an underlying condition.
If the eyes look hooded because of pronounced brow droop or a considerable amount of excess eyelid skin, Botox is decidedly ineffective. No injectable product can reduce or tighten the skin — the only solution is to have it surgically excised through upper eyelid surgery.
Upper eyelid surgery or blepharoplasty tweaks the deep structures of the upper eyelid to give the eyes a rested, pleasant appearance. The operation involves removing excess eyelid skin, repositioning fat and moving the muscles as needed to flatten and firm the lids.
Eyelid surgery is the better long-term option, and results last for many years. The eyes continue to age, albeit at a slower pace. Botox can also be a common cause of droopy eye lids. If you regularly receive Botox treatments and have suffered from droopy eye lids (ptosis) as a result, please let us know so we can consider this in our evaluation of your ptosis condition. We do not administer Botox at our clinic.


Your doctor may recommend ptosis surgery. During this procedure, the levator muscle is tightened. This will lift the eyelid up into the desired position. For children who have ptosis, doctors sometimes recommend surgery to prevent the onset of lazy eye (amblyopia).

Is it possible to prevent ptosis?

There’s no way to prevent droopy eyelids. Just knowing the symptoms and getting a regular eye exam can help you fight the disorder.

Children who show signs of droopy eye should be seen at your local optometrist, even if they don’t show signs of visual discomfort.

What’s the long-term outlook for people with ptosis?

Eyelid drooping isn’t usually harmful to your health. However, if your eyelids block your vision, you should avoid driving or operating heavy machinery until the condition has been assessed, and treated if needed.

The prognosis will depend on the cause of the droopy eyelid. However, since droopy eyelids can sometimes be a sign of a more dangerous condition, always consult your physician first.

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