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How Do I Know if I Have Eyelid Ptosis?

How Do I Know if I Have Eyelid Ptosis?

Tired and listless eyes can make one significantly older than they actually are. In many cases, this look is a result of Upper Blepharoptosis, or simply “ptosis”, a condition causing the upper eyelid to droop down over the eyes, making one look sleepy and inattentive. It can also significantly obstruct vision as patients struggle to open their eyes.

How can I tell if I have ptosis?

Ptosis is a genuine medical condition that should be diagnosed by a medical professional. However, if you are concerned, there are some general signs and symptoms you can look out for.

  • Tired looking eyes with droopy eyelids.

The most defining sign of ptosis is weak, droopy eyelids. This gives the bearer a constant “sleepy and tired” look as the eyes are unable to fully open.

  • Asymmetrical looking eyes

Another possible sign of ptosis is a noticeable asymmetry in the size of the eyes. Although there are many possible reasons causing one eye to appear bigger than the other, ptosis is one of the more common explanations.

  • Increased eye strain

Often, the weakened eyelid increases the effort required for the patient to open their eyes. Over time, this can strain the eye and eyelids, causing pain and aches in some cases.

  • Neck aches from a habit of tilting the head backwards

The upper eyelids obstructing vision can cause the patient to habitually tilt their head backwards in order to see better. Prolonged periods of doing this can cause the neck to ache.

If you experience some of the above signs and symptoms, perhaps it is time to consult a medical professional for a proper diagnosis, especially if you did not have them in the past and have acquired them over time.

Possible causes

There are many reasons that can cause ptosis:

  • Weakening of muscles caused by aging

The most common cause of ptosis is the weakening of the levator aponeurosis muscle, the muscle responsible for movement of the upper eyelids. As we age, this muscle may stretch and weaken, causing the eyelid to droop down noticeably. Occasionally, the muscle may detach completely from the eyelid, making patients unable to open their eyes.

  • Congenital

Occasionally, improper development can lead to a malformed levator aponeurosis muscle in one or both of the eyes, causing them to have ptosis from birth.

  • Prolonged wearing of contact lenses

Contact lenses may be convenient, but wearing them too often can stretch the upper eyelids. This can cause ptosis even with fully functional levator muscles.

  • Disease or injury affecting the eyes or face

In some patients, ptosis is caused by physical trauma or disease directly affecting the upper eyelids. For example, swelling and make the upper eyelid heavier and directly obstruct the opening of the eyes. Ptosis caused by these are usually temporary and will recover completely, only causing permanent damage in rare cases.

  • Underlying medical conditions of the brain

The eyes are often one of the first organs to be affected by any ailment of the brain. Hence, ptosis may be an indication of a mild stroke or a brain tumour. However, only a handful of ptosis cases are caused by a neurological condition so there is usually no need to worry.

Ptosis induced by brain damage will typically be accompanied by other symptoms like

  • General weakness of one side of the body
  • Persistent headaches
  • History of head injury

In these cases, patients will usually be referred to a neurologist for further examination.

Treatment for Ptosis

Ptosis is usually treated by surgically repairing the weakened or detached levator aponeurosis muscle, or in certain cases shortening the upper eyelid.
The surgeon will reattach and shorten the levator muscle from an incision along the upper eyelid. If needed, excess skin, fat and other tissue may also be removed before the incision is closed with sutures.

Ptosis repair surgery (Upper Blepharoplasty) is performed under anaesthesia so there will be minimal pain and discomfort.

On the other hand, if there is a suspected underlying condition causing your ptosis, the doctor will usually refer you to a relevant specialist for further examination before proceeding with ptosis repair surgery.


Ptosis is generally considered a minor condition. However, it can significantly affect your quality of life if not addressed. Also, it may rarely be an indication of a more serious ailment. Hence, it is always good to consult a medical professional for an examination.

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