Ptosis

Alternative names
Drooping eyelids

Definition
Ptosis is also called “drooping eyelid.” It is caused by weakness of the muscle responsible for raising the eyelid, damage to the nerves which control those muscles, or laxity of the skin of the upper eyelids.

Causes, incidence, and risk factors

Drooping eyelid can be caused by the normal aging process, a congenital abnormality (present before birth), or the result of an injury or disease.

Risk factors include aging, diabetes, stroke, Horner’s syndrome, myasthenia gravis, brain tumor or other cancer, which can affect nerve or muscle response.

Symptoms

     
  • Drooping of one or both eyelids  
  • Increased tearing  
  • If ptosis is severe, interference with vision.

Signs and tests

     
  • A physical examination to determine the cause  
  • Special tests may be done to evaluate suspected causes, such as myasthenia gravis

Treatment

If an underlying disease is found, the treatment may be specific to that disease. Most cases are associated with aging and no underlying disease will be found.

Surgical correction can be done to improve the appearance of the eyelids in milder cases if the patient desires it, and may be necessary to correct interference with vision in more severe cases. In children with ptosis, surgical correction may be necessary to prevent amblyopia.

Expectations (prognosis)

The expected outcome depends upon the cause. Surgical repair is usually very successful in restoring appearance and function.

Complications
If a drooping eyelid is left uncorrected in a child, it can lead to lazy eye.

Calling your health care provider

Drooping eyelids in children require prompt evaluation by an ophthalmologist.

New or rapidly changing ptosis in adults requires prompt evaluation by an ophthalmologist.

Johns Hopkins patient information

Last revised: December 2, 2012
by Arthur A. Poghosian, M.D.

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