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Ptosis (Droopy eyelid)

Ptosis (Drooping Eyelid)

Ptosis is the medical term for a drooping upper eyelid, which can affect one or both eyes. It can range from a mild droop that is mainly a cosmetic concern to a more severe droop that partially or completely covers the pupil and interferes with vision. Ptosis can be present from birth (congenital) or develop later in life (acquired), and there are different surgical techniques to repair it depending on the cause and severity.

 

What Causes Ptosis?

There are several causes of ptosis, including:

  • Age-related: The most common form in adults, due to gradual stretching or disinsertion of the muscle (levator) that lifts the eyelid. 

  • Congenital ptosis: Present from birth, usually due to underdevelopment of the levator muscle

  • Neurogenic: Related to nerve issues (e.g. third nerve palsy or Horner’s syndrome)

  • Myogenic: Related to muscle conditions like myasthenia gravis

  • Traumatic or post-surgical: Can result from injury or previous eye surgery

 

What Are the Symptoms of Ptosis?

  • Drooping of one or both upper eyelids

  • Difficulty keeping the eyes open or needing to raise the eyebrows to see

  • Visual obstruction, especially when reading or looking straight ahead

  • Tired or heavy-looking eyes

  • Uneven eyelid height or asymmetry in photographs

 

How Is Ptosis Treated?

The most effective treatment for ptosis is surgical repair to lift the eyelid and improve its position. The choice of technique depends on:

  • The strength of the levator muscle (the muscle responsible for lifting the eyelid)

  • The underlying cause

  • The desired aesthetic and functional outcomes

 

There are two main surgical approaches:

1. Anterior Approach (External Ptosis Surgery)

  • Involves a small incision in the natural eyelid crease

  • The surgeon directly tightens or advances the levator muscle

  • Suitable for most types of ptosis 

  • Allows precise adjustment of eyelid height and contour

  • Leaves a small scar hidden in the natural eyelid fold

  • Allows for simultaneous removal of excess upper eyelid skin

 

2. Posterior Approach (Internal or Muller's Muscle Surgery)

  • Performed from inside the eyelid, with no external incision

  • Best suited for patients with mild to moderate ptosis 

  • Shorter procedure and quicker recovery, with minimal visible swelling

 

Recovery After Ptosis Surgery

  • Most procedures are done under local anaesthetic with or without sedation

  • Mild swelling and bruising are expected and usually settle within 2 weeks

  • Vision is not typically affected, though the eyelid position may take some time to stabilise

  • Stitches (if external) are usually removed after 7 days

  • Final results are visible within 6-8 weeks, although refinement may continue over several months

 

Why Choose an Oculoplastic Surgeon?

Ptosis surgery is delicate and highly specialised. As an ASOPRS-trained and BOPSS-member oculoplastic surgeon, Miss Ting has advanced training in eyelid anatomy and function. She tailors each ptosis repair to the patient’s unique anatomy and needs, aiming for natural-looking results that restore both function and appearance.

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