# Ptosis (Drooping Eyelid)

URL: https://mohamedmohyudin.co.uk/conditions/ptosis/
Last reviewed: 2026-08-13

## Quick answer

Ptosis is a drooping of the upper eyelid below its normal position, ranging from mild to severe where the lid covers the pupil. In adults it can obstruct the upper visual field and cause a tired appearance; in children it must be treated urgently to prevent amblyopia. Oculoplastic surgery is highly effective at correcting it.

## Overview

Ptosis is a drooping of the upper eyelid below its normal position. It ranges from mild (barely noticeable) to severe (the lid covers the pupil completely). In children, severe ptosis must be treated urgently to prevent amblyopia (lazy eye). In adults, ptosis may cause visual field obstruction, a tired or asymmetric facial appearance, and the need to tilt the head back or raise the eyebrows to see clearly. Oculoplastic surgery is highly effective at correcting ptosis.

## Treatment

Surgical correction is the definitive treatment. Levator advancement is used for good levator function; frontalis sling (attaching the lid to the brow muscle) for poor levator function. NHS funding is available when formal visual field testing confirms significant superior field restriction. Private surgery provides the alternative for cosmetic correction or faster access.

## FAQs

### What causes a droopy eyelid?

Most droopy eyelids are due to age-related stretching of the eyelid muscle. Less commonly they are present from birth or linked to a nerve or muscle condition.

### When is a droopy eyelid serious?

A sudden droop, especially with double vision, a severe headache, a changed pupil, or weakness, needs urgent assessment, as it can occasionally signal a serious underlying problem.

### What causes a drooping eyelid?

The most common cause in adults is aponeurotic ptosis, an age-related loosening of the levator muscle attachment. Other causes include congenital ptosis present from birth, mechanical ptosis from the weight of an eyelid lesion, neurogenic causes such as Horner syndrome or third nerve palsy, myogenic conditions like myasthenia gravis, and trauma or previous eyelid surgery.

### How is ptosis diagnosed?

Diagnosis involves a clinical assessment that measures the margin reflex distance (MRD1), levator muscle function, and the upper visual field. Where indicated, systemic causes are excluded. In children, urgent assessment for amblyopia (lazy eye) is carried out, as severe ptosis must be treated promptly to protect developing vision.

### How is ptosis treated?

Surgical correction is the definitive treatment. Levator advancement is used when levator function is good, while a frontalis sling, attaching the lid to the brow muscle, is used when function is poor. NHS funding applies when visual field testing confirms significant superior field restriction; private surgery offers cosmetic correction or faster access.