Age-related (acquired) ptosis occurs when the edge of the upper eyelid falls too low. When the edge of the eyelid falls and covers part of the pupil, it blocks the upper part of your vision. In severe cases it is necessary to tilt one’s head back or lift the eyelid with a finger in order to see out from under the drooping lid.

In most cases, a drooping upper eyelid results from aging of previously normal structures. Typically, the tendon that attaches the “lifting” muscle to the eyelid stretches and the eyelid falls too low.

Since the muscle that lifts the eyelid has normal strength, surgical correction of a drooping upper eyelid that was once normal involves repairing the stretched tendon. It is not uncommon for one to develop a droopy upper eyelid following cataract surgery. The cataract surgery is apparently the “last straw” that causes a weak tendon to finally give way.

Surgery to repair ptosis is most commonly performed by eye plastic surgeon like Dr. Hsu who specialize in diseases affecting the eyelids, lacrimal (tear) system, the orbit (bone cavity around the eye), and cosmetic surgery.

Upper Eyelid Drooping Present Since Birth (congenital ptosis)

Ptosis is the medical term for drooping of the upper eyelid, a condition that may affect one or both eyes. Ptosis that is present since birth is called congenital ptosis.

The ptosis may be mild – in which the lid partially covers the pupil; or severe – in which the lid completely covers the pupil.

Children with significant ptosis may need to tilt their head back into a chin-up position, lift their eyelid with a finger, or raise their eyebrows in an effort to see from under their drooping eyelid(s).

While the cause of congenital ptosis is often unclear, the most common reason is improper development of the levator muscle. The levator muscle is the major muscle responsible for elevating the upper eyelid.

Children with congeital ptosis may also have amblyopia (“lazy eye”), strabismus (eyes that are not properly aligned or straight), refractive errors, astigmatism, or blurred vision. In addition, drooping of the eyelid may result in an undesired facial apperance.

Congenital ptosis is treated surgically, with the specific operation based on the severity of the ptosis and the strength of the levator muscle. If the ptosis is not severe, surgery is generally performed when the child is between 3 and 5 years of age (the “pre-school” years). However, when the ptosis interferes with the child’s vision, surgery is performed at an earlier age to allow proper visual development.

For more information, please visit

http://www.eyecareamerica.org/eyecare/conditions/ptosis/index.cfm