Sagging eyelid: causes and remedies of eyelid ptosis

Contrary to what one might think, aging is not one of the first causes of drooping eyelid, the most common cause is the improper development of the levator palpebrae muscle. If the problem is present at birth, it is better to intervene immediately for avoid further disturbances.

Here are some interesting natural remedies for puffy eyes:

  1. · Symptoms of eyelid ptosis
  2. Drooping eyelid: the causes
  3. · The doctor's diagnosis
  4. · How to cure drooping eyelid
  5. Diseases associated with drooping eyelid

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Eyelid ptosis symptoms

Eyelid ptosis is the technical name for droopy eyelid problem, but what are the symptoms that make you realize that something is wrong? The most evident is certainly the lowering of one or both eyelids.

Other symptoms include:

  • Difficulty closing or opening the eyes
  • Medium / severe sagging of the skin on and around the eyelid
  • Tiredness and pains around the eyes, especially during the day
  • Change in the appearance of the face


The appearance of the drooping eyelid may remain stable over time, develop gradually over the years, or be intermittent. Furthermore, the drooping eyelid may be only slightly hinted at, or completely cover the pupil and iris.

In severe cases, ptosis of the eyelid can completely prevent vision, especially when it affects both eyelids. In other situations, however, it can only be barely mentioned and therefore not immediately identifiable.

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A drooping eyelid can also simply change a person's appearance without compromising their health, but it can sometimes be a warning sign of a more serious disorder, affecting muscles, nerves, eyes or the brain.

Eyelid ptosis can occur even for just a few days or hours and is a sign of serious medical problems. In these cases, notify your doctor immediately.

Furthermore, this disorder is sometimes associated with strabismus and when it affects children, the tendency is to tilt the head back and raise the eyebrows to try to see better. This behavior, repeated over time, can lead to headaches and "ocular torticollis", causing neck problems and developmental delay.

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Sagging eyelid: the causes

The drooping eyelid usually arises with aging, as the muscles of the eyelids weaken. In adults, the most common cause of ptosis is levator strain, due to injury or side effects of certain eye surgery.

Other causes that lead to drooping eyelid are:

  • injuries
  • eye tumors
  • neurological disorders
  • diabetes
  • taking opioid drugs
  • drug use and abuse

Depending on the cause, we can distinguish different types of eyelid ptosis:

  • Myogenic ptosis: is due to a weakening of the levator muscle, common in patients already suffering from other eye diseases.
  • Neurogenic ptosis: when the nerves that control the levator palpebrae are also involved.
  • Aponeurotic ptosis: referred to advancing age or post-operative effects.
  • Mechanical ptosis: derives from a weighting of the eyelid which prevents its correct movement. Mechanical ptosis can result from the presence of a mass such as fibroids and angiomas.
  • Traumatic ptosis: occurs following laceration of the eyelid with excision of the levator muscle.
  • Neurotoxic ptosis: it is a classic symptom of poisoning, which requires immediate treatment.

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The doctor's diagnosis

The only one who can diagnose drooping eyelid is the doctor and better yet, who will do a careful examination of both eyelids, observing the entire eye socket.
Before proceeding with the problem assessment, the following measurements are made precisely:

  • Eyelid fissure: distance between the upper and lower eyelid in vertical alignment with the center of the pupil;
  • Reflected marginal distance: distance between the center of the pupillary light reflex and the upper and lower lid margin.
  • Levator muscle function.
  • Distance of the skin fold from the upper lid margin.

Other features that can help determine the cause of eyelid ptosis are:

  • Height of the eyelids;
  • Levator muscle strength;
  • Movements of the eye;
  • Abnormalities in the production of tears
  • Incomolete closure of the eyelid rim;
  • Presence / absence of double vision, muscle tiredness or weakness, difficulty speaking or swallowing, headache, tingling.

Sometimes further investigations are carried out by the ophthalmologist to determine the most effective treatment. For example, if the patient has signs of a neurological problem or if the eye exam reveals a mass inside the eye socket. case, specific tests will be prescribed.

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How to cure drooping eyelid

In less severe cases of drooping eyelid, targeted exercises may be enough to strengthen the muscle suitable for lifting the eyelid. There are glasses and specific contact lenses to support the eyelid and avoid surgery.

To correct a severe case of eyelid ptosis, the only solution is to resort to surgery, through an operation that reattaches and strengthens the levator muscles, with excellent results also as regards aesthetics.

If during the operation the surgeon notices that the levator muscles of the eyelid are very weak, he may decide to connect the eyelid to the eyebrow, so it will be the muscles of the forehead that have the task of lifting it.

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After the surgery it is normal not to be able to close your eyes completely, and above all it is important to know that this phenomenon could last for at least 2 or 3 weeks.

In exceptional cases, a second intervention may be necessary, especially to make the two eyelids perfectly symmetrical.

Complications that can occur after blepharoplasty include:

  • excessive bleeding
  • infection in the operated area
  • scarring and damage to facial nerves or muscles

Patients with eyelid ptosis should be regularly examined by an ophthalmologist to monitor the progress of the problem, even if they have not undergone surgery.

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Diseases associated with drooping eyelid

There are a number of diseases that can increase the risk of developing eyelid ptosis. Which ones are they? Here is the list.

  • Diabetes
  • Horner's syndrome
  • Myasthenia gravis
  • Stroke
  • Birth trauma
  • Brain cancer or other malignancies that can affect nerve or muscle reactions
  • Paralysis or injury of the 3rd cranial nerve (oculomotor nerve)
  • Trauma to the head or eyelids
  • Bell's palsy (damage to the facial nerve)
  • Muscular dystrophy

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