The four things you need to know about a drooping eyelid



Many patients come to our office in Denver looking to get their drooping eyelid fixed. A drooping eyelid or ptosis as it is called is one of the most common surgeries an eyelid specialist or oculoplastic surgeon performs. That being said, here are the four most common misconceptions that patients have about a ptosis repair.

  1. This can be a neurological issue

Ptosis or drooping of the eyelid can have many causes. Often the cause is aging of the muscle of the eyelid causing drooping of the eyelid itself. Though this is the most common cause there are several neurological causes that can cause a drooping eyelid.

Horner’s syndrome

Third Nerve palsy

Myasthenia Gravis

Oculopharyngeal Dystrophy

Previous Botox use

These conditions are neurological causes of ptosis or drooping eyelid and often are unrecognized as a cause for the drooping of the eyelid. The big deal is that a lot of the causes of ptosis that are neurological such as Horner’s syndrome or Third Nerve palsy can be brain tumors or aneurysms. As a neuro-ophthalmologist I first screen for these diseases before trying to fix the eyelid. There is no point missing a brain tumor or aneurysm but fixing the eyelid cosmetically. These diseases are complex and need to be screened for thoroughly.

  1. The surgery is not a guaranteed success

Ptosis repair involves tightening a muscle of the eyelid. This has nothing to do with loose skin of the eyelid. This surgery to raise the eyelid height has about a 90% success rate. I discuss this with patients before surgery and try to have patients understand that the biggest risk of the surgery is overcorrection or undercorrection. As a ptosis surgeon who regularily repairs drooping eyelids I discuss with patients that one of ten patients needs to have a second surgery to get the eyelid position just right. This may be a touch up in the office or sometimes a reoperation in the operating room.

  1. This is totally different than an eyelift

Most patients think that ptosis repair or surgery for a drooping eyelid is an eyelift. I have to explain to them that this is not an eyelift. An eyelift is when the fat and skin of the eyelid is removed to improve the cosmetic appearance of the eyelid. A ptosis repair or raising a drooping eyelid is done to raise the height of the eyelid so patients can see properly.

  1. This can be related to contact lens use or eye surgery

Other than aging or neurological problems what can cause a drooping eyelid? A drooping eyelid can be caused by a weakened muscle of the eyelid from surgery or contact lens use. During eye surgery, an instrument called a speculum is placed in the eye to open the eye for surgery. This instrument can also stretch the muscle of the eyelid. There is no way around this. As a result a patient may need ptosis surgery after cataract surgery, lasik surgery or any other eye surgery.

Contact lenses can inadvertently stretch the muscles of the eyelid. This is through stretching the eyelid gently as the small piece of plastic on the eye displaces the muscle over years. Also, the chronic manipulation of the eyelid to place the contacts each morning and night can also stretch the eyelid.

These are common unknown facts patients do not know about a drooping eyelid or ptosis. Make an appointment at our office to see an oculoplastic surgeon such as myself who can guide you towards the best decision of what to do about your ptosis of your eyelid. As a Denver eyelid specialist our practice focuses on drooping eyelids, their neurological causes and fixing them properly through surgery and medications.


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