What are the symptoms of droopy eyelids?
Droopy eyelids may also be associated with:
- Bell’s Palsy
- Microvascular Cranial Nerve Palsy
- Myasthenia gravis
- Horner’s syndrome
- Long-term contact lens use
- History of facial trauma or ocular surgery
- History of thyroid problems or Graves’ disease
What causes droopy eyelids?
The most common cause of a droopy eyelid is a loss of elasticity in the eyelid skin, causing redundancy and sagging. This is known as dermatochalasis and is associated with the natural aging process. Rarely, dermatochalasis can be seen in association with systemic diseases and with regard to younger people. This causes the eyes to appear half-open and is known as ptosis.
Another common cause of droopy eyelids is the separation or stretching of the levator muscle tendon, the muscle that lifts the tendon from the eyelid. Ptosis typically occurs as a result of aging but can also occur after cataract surgery, eye surgery or as a result of an injury.
Ptosis commonly occurs later in life without associated diseases. However, there are a number of systemic disease processes that affect the innervation or function of the levator muscle, which can result in drooping of the eyelid. Common causes include cranial nerve palsy, Horner’s syndrome, myasthenia gravis and trauma to the eyelid and surrounding structures.
Congenital ptosis is typically caused by improper development of the levator muscle. Although it is usually an isolated finding, those born with ptosis may also have eye-movement abnormalities, muscular diseases, lid tumors or other tumors.
What are droopy eyelids?
With dermatochalasis, excessive and redundant skin hangs over the natural eyelid crease and, in advanced stages, the skin can drape over eyelashes and even over the pupil. Dermatochalasis frequently obstructs the superior visual field.
People with advanced dermatochalasis can lose more than 50% of their visual field and have difficulty performing normal daily activities, including driving, reading, computer work and outdoor activities. Additionally, people with dermatochalasis can have ocular irritation, dermatitis or inflammation of the eyelid skin, misdirection of eyelashes and dry eyes.
People with eyelid ptosis commonly complain of their eyelids feeling heavy and are frequently told that they look tired. Ptosis causes an inability to open the eyes all the way or can only do so with effort. As with dermatochalasis, ptosis can severely constrict a person’s functional vision. The presence of double vision, abnormal pupil size, weakness and other neurological deficits should prompt evaluation of other causes of the ptosis.
Congenital ptosis is typically present at birth and can range from very mild drooping, seen more when the person is tired, to severe drooping that can potentially cause poor vision development.
Can droopy eyelids be prevented?
In most cases, droopy eyelidscannot be prevented. However, there are treatments available for this condition. (link to droopy eyelid treatments page)
How can droopy eyelids impact my life?
The most serious symptom is poor vision, even in early ptosis and with moderate dermatochalasis.
With this condition, the upper field of vision is obstructed. With moderate to severe ptosis and dermatochalasis, people often complain of difficulty with daily activities due to the lack of peripheral vision. Often, people feel like they have trouble seeing surrounding cars and oncoming traffic while driving.
Additionally, people with dermatochalasis or ptosis complain of constantly straining to keep their eyes open and raising their eyebrows to improve their sight. This can cause tension headaches that occur later in the day.
Because droopy eyelids tend to lead to constant blurriness of visual images, it can lead to other serious conditions.
How are droopy eyelids treated with blepharoplasty?
An eye doctor will diagnose droopy eyelids by carefully examining the eyelids. He or she will take detailed measurements of the height of the eyelids and will assess the strength of the eyelid muscles.
Surgery can be an effective treatment for ptosis and dermatochalasis, improving vision as well as cosmetic appearance. It is very important that those with droopy eyelidshave regular ophthalmic examinations to monitor their vision and prevent severe vision loss from untreated amblyopia (also known as “lazy eye”, it is the loss of ability to see details).
In most cases, the treatment for droopy eyelids is surgery. In children, if amblyopia is present, treatment with patching, eyeglasses, or eye drops may be necessary. In determining whether or not surgery is necessary, an ophthalmologist will consider a few important factors:
- The patient’s age
- Whether one or both eyelids are involved
- The eyelid height
- The eyelid’s lifting and closing muscle strength
- The eye’s movements
Dermatochalasis, or excessive eyelid skin, is corrected with blepharoplasty. During this surgery, the surgeon removes the redundant skin and underlying fat. In ptosis repair surgery, the levator tendon and muscle is tightened to raise the eyelid height.
During surgery, the eyelid-lifting muscle (levator) is tightened. In the case of severe ptosis, when the levator muscle is extremely weak, the lid can be attached or suspended from under the eyebrow so that the forehead muscles can do the lifting.
Your ophthalmologist will determine the cause of the droopy eyelid and plan the best treatment.
When is the right time for blepharoplasty to be performed?
Blepharoplasty is a surgical procedure and is frequently covered by insurance or Medicare. It is a very popular cosmetic procedure with thousands of blepharoplasty surgeries being performed each year. This is an outpatient procedure and will be customized to each patient’s specific requirements. Using surgical incisions and precise suture placements, we will be able to recreate the natural lines of the eyelids in order to prevent any visible scarring.
What can I expect from blepharoplasty surgery?
The risks of blepharoplasty surgery include infection, bleeding, and reduced vision, but these complications are very rare. Immediately after surgery, you may find it difficult to completely close your eye, but this is only temporary and is due to post-operative swelling. Lubricating eye drops and ointment can be helpful during this period.Patients are instructed to rest and use frequent ice packs following surgery.
Although improvement of the lid height is achieved, the eyelids may not appear perfectly symmetrical. This can be due to asymmetries present before surgery, such as raising one eyebrow, or asymmetry in the healing process. In rare cases, an additional procedure is required for optimal results.
What’s next? Get a blepharoplasty evaluation
Patients must undergo a complete medical evaluation prior to upper eyelid surgery. Any current medical conditions will need to be covered when discussing treatment. Whether only cosmetic or functional, the upper lid blepharoplasty or ptosis repair will have to be thoroughly discussed with the surgeon.
Your doctor will be able to answer any eyelid surgery questions that you may have, ensuring that you receive the best treatment available on the market today.
Why choose Eye Centers of Florida for your evaluation?
At Eye Centers of Florida, we have highly qualified doctors available to offer you world-class treatment for eye conditions. We are proud of our long history of service and on having built lifelong relationships with our patients.
If you would like to be evaluated and or treated for droopy eyelids, contact or visit us at any of the following Eye Centers of Florida locations:Bonita Springs | Cape Coral | Clewiston | Fort Myers – Main Clinic & Surgery | Fort Myers – Aesthetic Center | Fort Myers, East | Fort Myers, South | Immokalee | LaBelle | Lehigh Acres | Naples, North | Naples, South | Port Charlotte
With Eye Centers of Florida, you’ll have access to highly qualified eye care specialists and world-class care for your droopy eyelids.