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What causes droopy eyelid? 16 possible conditions

What Is Ptosis?

Ptosis is the medical term for a drooping eyelid. It refers only to the upper eyelid; it does not refer to lower eyelid sagging. Upper eyelid drooping can sometimes affect your vision if the drooping is severe. Ptosis is not a disease, but a symptom of another condition that must be treated.

What Causes Ptosis?

Ptosis can be caused by a number of factors that affect the muscles, nerves, or skin of the eyelids. The muscles that allow your eyelids to move up and down—called the levator muscles—can become weakened from age or injury. In addition, some people may be born with weaker-than-normal eye muscles, thereby developing ptosis at a young age.

Nerve damage can contribute to ptosis as well. A common cause of ptosis is Horner syndrome. Horner syndrome is a form of nerve damage that occurs in the face and eyes, and is usually the result of an underlying condition. Stroke and other brain injuries, spinal cord injuries, and some forms of lung cancer can cause Horner syndrome and ptosis.

Some chronic conditions, including diabetes and myasthenia gravis, may also increase your risk of ptosis. Diabetes—your body’s inability to process sugar correctly—can lead to a number of complications, including eye disease. Myasthenia gravis is an autoimmune disease that affects the way your muscles and nerves communicate.

Cluster headaches can also cause ptosis in some people. Cluster headaches are severe headaches that strike in a frequent pattern for a period of time (cluster periods) and then go into remission.

Symptoms of Ptosis

The primary symptom of ptosis is a visible drooping of the upper eyelid. Ptosis can affect children and adults at any stage of life. You may notice symptoms in one or both eyes. Individuals who are born with drooping eyelids have congenital ptosis. One of the signs of congenital ptosis is having uneven creases in the eyelids.

Children who have ptosis may use certain gestures or body positions common to people with this symptom. Frequent eyebrow raising and head tilting can indicate that ptosis is interfering with normal sight.

Diagnosing Ptosis

The American Academy of Ophthalmology stresses the importance of eye exams for children and adults with ptosis (EyeCare America). A vision test that uses an eye chart can help determine if eyelid drooping is compromising your or your child’s vision.

Blood tests used to detect diabetes and autoimmune conditions can help diagnose the underlying cause of ptosis. Your doctor may also perform X-rays to see if structural abnormalities around the eye(s) are causing the problem.

Treating Ptosis

Treatment for ptosis varies. If diabetes is the cause, your doctor will teach you how to manage this condition. Drooping eyelids caused by spinal cord injuries, tumors, nerve damage, or cancer may resolve once the underlying condition is addressed.

If myasthenia gravis is to blame, you doctor will likely prescribe medication to ease ptosis and other symptoms of this disease. Medications, such as neostigmine and pyridostigmine, may help your muscles and nerves to work together more effectively. Your doctor may also prescribe prednisone or other immunosuppressant drugs.

In cases of congenital ptosis, the levator muscles usually do not improve on their own, and may require surgery. Surgical repair involves manually tightening the levator muscles in order to lift the eyelid. You may have trouble opening and closing your eye immediately after surgery, but as you recover, this function will return. An eyelid lift can restore normal vision in many cases.

Children who have ptosis are at an increased risk for developing a lazy eye. Lazy eye, called amblyopia, is the blurring or absence of vision in one eye. Amblyopia occurs when the nerve connections between your brain and eye are impaired. One treatment for this condition involves putting a patch over your good eye in order to make your poor eye work more efficiently. Surgical repair for ptosis can help prevent lazy eye.

Outlook for Ptosis

The underlying cause of ptosis plays a major role in determining the outlook for individuals with this condition. Surgery can be very successful in restoring vision and eye function, as well as the appearance of the eye. In some cases, however, even after surgery your eyelids may not look entirely symmetrical.

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See a list of possible causes in order from the most common to the least.


Diabetic Neuropathy

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Stroke Overview

This condition is considered a medical emergency. Urgent care may be required.

A stroke (a "brain attack") is a medical emergency in which part of the brain is deprived of oxygen. This occurs when an artery that supplies oxygenated blood to the brain becomes damaged and brain cells begin to die.

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Muscular Dystrophies

Muscular dystrophies are a group of inherited diseases that damage and weaken your muscles over time. This damage and weakness is due to the lack of a protein.

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Myasthenia Gravis

Myasthenia gravis is a neuromusclar disorder. It results in weakness of the skeletal muscles, and can cause double vision and drooping of the eyelid.

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Botulism (or "botulism poisoning") is a rare, but very serious illness that is transmitted through a very common source-the food we eat. Botulism poisoning is caused by a type of bacteria that is present everywher...

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Brain Aneurysm

This condition is considered a medical emergency. Urgent care may be required.

An aneurysm in the brain is a weak area in an artery in the brain that bulges out and fills with blood. It can be unpredictable and life-threatening, and can cause extremely serious conditions.

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Adult Brain Tumor

A brain tumor is the growth of abnormal cells in your brain. Whether the growth is cancerous or not, any brain tumor is serious. Symptoms can include both cognitive and physical control problems.

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Intracranial Hemorrhages

Intracranial hemorrhage (ICH) is bleeding inside the skull. It is a life-threatening emergency. If you think you or someone you know is experiencing ICH, go to the emergency room right away or call 911. There are fou...

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Pituitary Cancer

The pituitary gland is a very small gland of major importance to the functioning of the human body. It is located directly behind the eyes and below the front of the brain. It is about the size of a pea. Despite it...

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Necrotizing Vasculitis

This condition is considered a medical emergency. Urgent care may be required.

Necrotizing vasculitis is the inflammation of blood vessel walls. It can interrupt blood flow, causing skin, muscle, and blood vessel damage.

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Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff syndrome (WKS) is a type of brain disorder caused by a lack of vitamin B1. The syndrome is actually two separate conditions that can occur at the same time. Usually you'll experience symptoms o...

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Turner Syndrome (Monosomy X)

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Aarskog Syndrome

Aarskog syndrome is a very rare genetic disorder caused by a mutation on the X-chromosome that can affect a child's stature, facial features, genitalia, muscles, and bones. It primarily affects males.

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Aase Syndrome

Aase syndrome is a rare, potentially genetic condition characterized by several birth defects. These include a reduced number of red blood cells from birth and three bones in one or both thumbs, instead of two.

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Shingles is an infection caused by the varicella-voster virus, which also causes chickenpox. Following pain and burning,fluid-filled blisters that break easily are common symptoms.

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Non-Small Cell Lung Cancer

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Swelling of the face is one potential sign of lung cancer.

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.