Ptosis is the medical term for drooping of the upper eyelid, a condition that may affect one or both eyes. When the edge of the upper eyelid falls, it may block the upper field of your vision. Ptosis that is present at birth is called congenital ptosis.

Symptoms of ptosis include a decreased ability to keep your eyes open, eyestrain and eyebrow fatigue from the increased effort needed to raise your eyelids, and fatigue, especially when reading.

In severe cases, it may be necessary to tilt your head back or lift the eyelid with a finger in order to see out from under the drooping eyelid(s). You may also notice that you have a tired appearance from "droopy eyelids" even though you are well rested.


Acquired ptosis is most commonly due to stretching of the levator muscle in the eyelid. The levator muscle is the major muscle responsible for elevating the upper eyelid. Another cause of acquired ptosis is interference with the nerve supply to the muscle. Acquired ptosis may occur as a result of aging, trauma, or muscular or neurologic disease.

As you get older, the tendon that attaches the levator muscle to the eyelid stretches and the eyelid may fall, covering part of the eye. It is not uncommon for a patient to develop upper eyelid ptosis after cataract surgery, which can sometimes cause the weak tendon to stretch.

Acquired ptosis can also be caused by injury to the oculomotor nerve (the nerve that stimulates the levator muscle), or following severe trauma to the eye's orbit that injures the tendon connecting the levator muscle to the eyelid.

Acquired ptosis may also be the first sign of myasthenia gravis, a disorder in which the body’s muscles become weak and tire easily. Ptosis is also present in people with Horner's Syndrome, a neurologic condition that affects one side of the face and indicates injury to part of the sympathetic nervous system.


While the cause of congenital ptosis is often unclear, the most common reason is improper development of the levator muscle.


Acquired ptosis is treated surgically, with the specific operation based on the severity of the ptosis and the strength of the levator muscle. Surgery is designed to reattach the stretched muscle to its normal location. If there is poor strength in the levator muscle, a "sling" may be used to enable the forehead muscles to elevate the eyelid.

If congenital ptosis is not severe, surgery is generally performed when the child is between 3 and 5 years of age. However, when the ptosis interferes with the child's vision, surgery is performed at an earlier age to allow proper visual development.

The main goals of ptosis surgery are elevation of the upper eyelid to restore normal field of vision and an attempt to achieve symmetry with the opposite upper eyelid. These goals depend on many factors and, therefore, may not always be possible to achieve.

Surgery is usually performed with local anesthesia, which numbs the upper eyelid, and with the patient lightly sedated with oral and/or intravenous medications. Some surgeons prefer to use general anesthesia, in which case the patient will sleep through the operation.