How to Fix a Droopy Eyelid

A droopy eyelid could be sagging skin above the eye or it could be a medical condition called ptosis. How to fix a droopy eyelid depends on the cause.

ptosis woman with droopy eyelid

Ptosis can occur from aging, muscle disease, or injury.

© Rungrudee | Getty Images

Droopy upper eyelids that occur with age affect both eyes. Your eyelids themselves don’t really droop. The skin above your eyelids gets loose and droops over your lids. As you age your skin loses fat and elasticity, becoming thin and saggy. Because the skin of your eyelids is some of the thinnest skin in your body, it can stretch and sag with gravity. Sun damage can also contribute to weak and thinning skin.

Ptosis – from the Greek word for falling – is the medical term for weakness of the muscle that lifts your eyelid, called the levator muscle. Ptosis causes your lid to drop down over your eye. You would have to use your finger to lift it. About 11 to 12 percent of adults develop this condition. Ptosis may drop your lid over your whole eye or half your eye. It can be on one side or both sides. Causes of ptosis include:

  • Congenital ptosis: Babies are born with ptosis due to a failure of the levator muscle to develop properly. It is more common in boys, and usually affects one eye.
  • Ptosis from nerve or muscle disease: This type occurs if a nerve condition affects the eyelid muscles. Examples include diseases like multiple sclerosis or myasthenia gravis.
  • Ptosis due to injury: This can include scaring of the eyelid from a cut or a broken eye bone. Surgery or eye infections can also injure the eye muscles or nerves.
  • Ptosis from aging: This is due to stretching and weakness of the levator muscle that occur over time.

Learn more about other common eye conditions. 

How to Fix Droopy Eyelids or Ptosis

Droopy eyelids may be treated if they interfere with vision. They may also be treated for cosmetic reasons. Options include injections that tighten or fill sagging eyelids, including Botox. Cosmetic Surgery to remove excess sagging skin from above the eyelid is called blepharoplasty. This may be done along with other facial plastic surgeries like a face lift or brow lift.

The most effective treatment for ptosis is surgery. This surgery can be done under local anesthesia as an outpatient, children may need general anesthesia. During the procedure, an eye surgeon makes a small incision in the eyelid and places a small stitch to tighten the levator muscle.

A new option for ptosis is an eyedrop medication. It is called oxymetazoline, the same medicine used in the nasal spray Afrin. When used in the eye, it tightens (contracts) the levator muscle and lifts the eyelid. The brand name is Upneeq. This treatment is not approved for children under age 13 and it needs to be prescribed by a doctor. This medicine does not cure ptosis. It needs to be used every day, but it may be an option for some people who can’t have surgery.

Droopy Eyelid Exercises

According to the Cleveland Clinic, there are no exercises for droopy eyelids. Your levator muscles gets all the exercise they need by blinking about 30,000 times per day.  There are also no eye exercises recommended for ptosis.

You may have heard of facial exercises called facial yoga. These exercises are said to make your face look younger by increasing cheek fullness and muscle tone. They have not been shown to have any benefits for droopy eye or ptosis.

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Chris Iliades, MD

Dr. Chris Iliades is board-certified in Ear, Nose and Throat and Head and Neck Surgery from the American Board of Otolaryngology and Head and Neck Surgery. He holds a medical … Read More

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