Droopy eyelids, also called ptosis, is a condition that affects one or both upper eyelids. Patients may experience increased tearing, irritation or difficulty closing the eye(s). Ptosis can also cause problems with vision, especially during reading, leading to headaches, eye fatigue and double vision.

Ptosis can be present at birth or may be acquired later in life. Some of the most common causes include laxity of the skin from aging, stretching or tearing of the tissue connecting the muscle and skin and long-term use of contact lenses. Excess skin or tissue (like from a tumor or scar tissue) can weigh down the upper eyelid and limit the ability of the muscles to pull it up. Ptosis can also be caused by nerve disease or trauma.

Surgery for Ptosis

Corrective surgery for ptosis is called blepharoplasty. The American Society for Aesthetic Plastic Surgery estimates, last year, more than 240,000 of the procedures were performed in the U.S. The surgery is typically done for cosmetic reasons to balance the look of the eyelids or rejuvenate the face. But it can also be used to correct droopy eyelids that cause vision problems for the patient.

Allan Wulc, M.D., an Eye and Facial Plastic Surgeon with Cosmetic & Plastic Surgery Specialists, says the surgery needs to address the underlying cause of the problem and should be tailored to the patients' needs. He prefers to do the surgery in an operating room with intravenous sedation (rather than general anesthesia). That allows the patient to be awake and responsive during the initial stages of the procedure. Once the initial steps are performed, the patient sits up, allowing Wulc to see if the results produce a balanced appearance. The patient then lies back down and is given deeper sedation so the results can be fine tuned. The incision, hidden in the natural crease of the eyelid, is closed with dissolvable stitches.

After surgery, the patient usually only needs over-the-counter pain medication and ice to reduce swelling. Bruising can be significant and generally lasts one to two weeks.

Wulc says ptosis correction should be performed by a facial plastic surgeon or ocular plastic surgeon with experience in eyelid procedures. He also recommends a consultation with an ophthalmologist to reduce risk of potential complications, like dry eye. Patients who have had LASIK surgery should wait at least six months before having eyelid surgery. Conversely, patients who have had eyelid surgery should wait at least six months before having LASIK.

Wulc says blepharoplasty is typically considered a cosmetic procedure and not generally covered by health insurance. However, if a visual field test determines the condition is causing a functional vision impairment, it may be covered.

For general information on ptosis:

Eye Care America