Ptosis
Ptosis is a drooping of the upper eyelid that can affect vision and cause eye fatigue. Surgical correction can restore eyelid position, improving both visual function and comfort.Ptosis refers to the drooping of the upper eyelid. The degree of drooping can vary from mild – where the eyelid sits slightly lower than normal – to more significant cases where the eyelid partially or completely covers the pupil and obstructs vision.
It may affect one or both eyes and is often asymmetrical. While some people are born with ptosis, it more commonly develops over time as part of the natural ageing process.
What Is Ptosis?
The position of the upper eyelid is controlled by the levator muscle, which lifts the eyelid. Ptosis occurs when this muscle or its tendon becomes weakened, stretched or detached.
Age-related ptosis is the most common form and typically develops gradually. It may also be associated with:
- Contact lens wear
- Previous eye surgery (such as cataract surgery)
- Chronic eyelid inflammation
- Trauma
- Less commonly, neurological conditions
In some cases, ptosis is present from birth (congenital ptosis), while in others it may be inherited.
Because the eyelid plays an important role in both vision and eye protection, changes in its position can affect both function and comfort.
Symptoms
Symptoms depend on the severity of the eyelid droop and may include:
- Reduced or obstructed field of vision
- Difficulty reading, driving or performing visual tasks
- A heavy or tired sensation in the eyelids
- Forehead or brow ache from compensating by raising the eyebrows
- Needing to tilt the head back to see clearly
- A general sense of eye fatigue
In some cases, patients may not notice the drooping itself but instead experience the strain of constantly trying to lift the eyelids.
Next Steps
If you are experiencing visual obstruction, eyelid heaviness or fatigue, an assessment can determine whether ptosis is the underlying cause.
Treatment is guided by the degree to which the eyelid position affects vision, comfort and daily activities.
Assessment & Diagnosis
Evaluation includes:
- Measurement of eyelid position and function
- Assessment of the levator muscle strength
- Examination of the visual field
- Assessment for any underlying neurological or ocular conditions
This allows your specialist to determine the cause of ptosis and whether treatment is appropriate.
Treatments
Treatment depends on the severity of ptosis and its impact on vision and quality of life.
In mild cases, where vision is not affected and symptoms are minimal, observation may be appropriate.
Surgical Correction
Surgery is the primary treatment for ptosis when vision or function is affected.
Procedures are typically performed as a day surgery under local anaesthetic with sedation and may include:
- Lid crease approach
A small incision is made in the natural eyelid crease, allowing the levator muscle to be tightened. This approach also allows removal of excess skin where required, with minimal visible scarring.
- Posterior (internal) approach
Surgery is performed from the inside of the eyelid, avoiding a skin incision.
- Frontalis sling (silicone sling)
In cases where the levator muscle is not functioning, a sling may be used to connect the eyelid to the brow muscles, allowing the forehead to assist in lifting the eyelid.
The most appropriate technique is determined based on the underlying cause and severity of the ptosis.
Recovery & Aftercare
Following surgery:
- Mild swelling or bruising may occur temporarily
- Eye drops or ointments are prescribed to support healing
- Follow-up appointments monitor eyelid position and function
Most patients experience significant improvement in both vision and comfort.
With appropriate treatment, ptosis can be effectively corrected, restoring a more natural eyelid position and improving visual function.