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Eyelid drooping

Eyelid drooping is excessive sagging of the upper eyelid.

Considerations

A drooping eyelid can stay constant, worsen over time (progressive), or come and go (intermittent). It can be one-sided or on both sides. When drooping is one-sided (unilateral), it is easy to detect by comparing the two eyelids. Drooping is more difficult to detect when it occurs on both sides, or if there is only a slight problem.

A furrowed forehead or a chin-up head position may indicate that someone is trying to see under their drooping lids. Eyelid drooping can make someone appear sleepy or tired.

Drooping lids are either present at birth (congenital) or develop later in life. A drooping eyelid is usually not a serious problem, but your health care provider will need to examine your eyes and lids.

Causes

Drooping eyelids may be due to a variety of conditions include aging, diabetes, stroke, Horner syndrome, myasthenia gravis, or a brain tumor or other cancer that affects nerve or muscle reactions. Below are some common causes.

Both eyelids drooping:

One eyelid drooping:

  • Growth in the eyelid, such as a stye
  • Medical problem
  • Nerve injury
  • Normal aging process
  • Normal variation

Home Care

Below is a list of recommendations based on the various causes of eye drooping:

  • Caused by aging -- no treatment is necessary, unless it affects your vision.
  • Caused by an allergic reaction -- consult your health care provider about antihistamine or steroid treatment.
  • Caused by nerve injury -- consult your health care provider about surgical correction.

For all other causes -- follow your health care provider's recommendations.

When to Contact a Medical Professional

Contact your health care provider if:

  • Eyelid drooping is affecting your appearance or vision
  • One eyelid suddenly droops or closes
  • It is associated with other symptoms, such as double vision

What to Expect at Your Office Visit

Your health care provider will get a medical history and perform a physical examination.

Medical history questions may include:

  • Are both eyelids affected or just one?
  • How long has this been present?
  • Is it getting worse or staying the same?
  • Is it present all of the time or only sometimes?
  • What other symptoms do you have?

The physical examination may include a detailed assessment of nerve functioning.

Diagnostic tests that may be performed include:

Interventions:

Surgery may be necessary to correct problems with the muscles that open the eyelid (levator muscle dysfunction).

You may get special spectacle frames that suspend the eyelid by traction with a wire. Usually these frames help patients with temporary, partial paralysis, or those who are not good candidates for surgery.

After seeing your health care provider:

You may want to add a diagnosis related to eyelid drooping to your personal medical record.

References

Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 431.

Custer PL. Blepharoptosis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier; 2008:chap 12.5.

Updated: 8/14/2012

Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


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