Eyelid drooping

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Definition
This is excessive drooping of the upper eyelid(s). See also drooping eyelid disease (ptosis).

Considerations

Drooping eyelids can be constant, progressive, or intermittent. It can be one-sided, or on both sides. When drooping is one-sided (unilateral), it is easy to detect by comparing the relative position of the eyelids. Drooping is more difficult to detect when it occurs on both sides, or if there is only a slight problem.

A furrowed forehead or a chin-up head position may indicate that someone is trying to see under their drooping lids. Eyelid drooping can make someone appear sleepy or tired.

Drooping lids are either congenital (present at birth) or acquired later in life. A drooping eyelid is not a reason to panic, but should be reported to the doctor.

Common Causes

Both eyelids

• Normal variation of the eyelids
  
• Normal aging process
  
• Migraine headaches
  
• Medical problem such as myasthenia gravis

One eyelid drooping

• Normal variation
  
• Normal aging process
  
• Nerve injury
  
• A growth in the eyelid such as a stye
  
• Medical problem

Home Care

Below is a list of recommendations based on various causes for eye drooping.

• Caused by nerve injury—consult your doctor about surgical correction.
  
• Caused by an allergic reaction—consult your doctor about antihistamine or steroid treatment.
  
• Caused by aging—no treatment is necessary.
  
• All other causes—follow your health care provider’s recommendations.

Call your health care provider if

• One eyelid suddenly droops or closes.
  
• Eyelid drooping is affecting appearance or vision.
  
• It is associated with other symptoms such as double vision.

What to expect at your health care provider’s office
The medical history will be obtained, and a physical examination performed.

Medical history questions documenting drooping eyelids in detail may include:

• Are both eyelids affected or just one?
  
• How long has this been present?
  
• Is it getting worse or staying the same?
  
• Is it present all of the time or only sometimes?
  
• What other symptoms are also present?

The physical examination may include a detailed assessment of nerve functioning.

Diagnostic tests that may be performed include:

• Slit-lamp examination
  
• Tensilon test

Interventions:
Surgery may be necessary to correct levator muscle dysfunction (problems with the muscles that open the eyelid).

Special spectacle frames that suspend the eyelid by traction with a wire may be provided. Usually these frames are used to help patients with temporary, partial paralysis, or those who are not good candidates for surgery.

AFTER SEEING YOUR HEALTH CARE PROVIDER:
You may want to add a diagnosis related to eyelid drooping to your personal medical record.

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