Eyelid drooping, or ptosis, occurs when the upper lid sits lower than normal and may cover part of the pupil. It can be congenital or acquired.
Common Causes
Age‑related stretching of the lid tendon, previous surgery or contact lens wear, and nerve or muscle disorders such as third nerve palsy or myasthenia gravis can all lead to ptosis. Trauma and tumours in the orbit or brain are less common but important causes.
- Sudden onset ptosis with double vision or pupil changes can indicate serious neurological disease
- Long‑standing mild ptosis may be purely cosmetic but still affect vision in children
- Horner’s syndrome causes subtle drooping with small pupil and reduced sweating
- Myasthenia gravis often produces variable drooping that worsens with fatigue
Assessment and Treatment
Evaluation includes checking eyelid position, eye movements, pupil size, and strength, often with neurological input. Management ranges from observation and surgery to systemic treatment of underlying disease.
- Children with significant ptosis require early review to prevent lazy eye
- Adults troubled by obstruction of vision or appearance may benefit from lid surgery
- Urgent care is needed if ptosis appears suddenly with other neurological signs
- Detailed history helps distinguish mechanical, neuromuscular, and neurogenic causes
