What Is Ptosis? Ptosis, also known as a drooping eyelid, refers to the downward displacement of the upper eyelid that covers part of the eye. This condition may affect one or both eyes and can range from mild (barely noticeable) to severe (obstructing vision). Ptosis is caused by weakness or dysfunction of the levator muscle, which is responsible for lifting the eyelid. It can occur at any age, but is more common among older adults due to natural tissue aging. In severe cases, ptosis may interfere with vision, appearance, and even self-confidence. Causes of Drooping Eyelid (Ptosis) Ptosis may be congenital (present at birth) or acquired later in life. Common causes include: Age-related changes: The most common cause; muscle or tendon stretching with age Levator muscle dysfunction: Weakening or detachment of the muscle that lifts the eyelid Nerve damage: Due to conditions like third nerve palsy or Horner’s syndrome Eye trauma or previous eye surgery: Such as cataract or LASIK procedures Neurological diseases: Including myasthenia gravis or muscular dystrophy Congenital ptosis: Poor development of the levator muscle from birth Tumors or growths in the upper eyelid pressing on eyelid structures Symptoms of Ptosis The primary symptom is visible drooping of one or both eyelids, but patients may also experience: Obstructed or reduced vision, especially in severe cases Increased forehead wrinkling from constantly raising the eyebrows Eye fatigue or heaviness, particularly toward the end of the day Head tilting to improve vision (especially in children) Difficulty keeping the eye open, leading to frequent blinking or squinting Cosmetic concerns, affecting appearance and facial symmetry In children, congenital ptosis may also lead to amblyopia (lazy eye) or strabismus (misalignment) if not treated early. When to See an Eye Specialist Seek medical evaluation if: Ptosis is interfering with your vision The drooping worsens over time It's accompanied by other symptoms like double vision, numbness, or headaches The ptosis developed suddenly You notice unequal pupil size or eye movement difficulties Prompt evaluation is crucial to rule out neurological causes or emergent conditions such as brain aneurysms or tumors. Diagnosis of Ptosis at Bangkok Eye Hospital At Bangkok Eye Hospital, ptosis diagnosis begins with a detailed eye and neurological exam, which may include: Eyelid measurements: To assess the degree of droop and levator function Visual field testing: To determine how much the ptosis affects sight Slit-lamp examination: To evaluate eyelid structure and corneal health Neurological assessment: If nerve damage or muscular disorders are suspected Photographic documentation: For before-and-after comparisons in surgical cases Advanced imaging may be requested if a tumor or systemic disease is suspected. Treatment Options for Ptosis Treatment depends on the cause, severity, and impact on vision and quality of life. Non-Surgical Options Ptosis crutches: Special attachments added to glasses to lift the eyelid Eye exercises: Rarely effective except in very mild or neurologically based cases Observation: For mild or stable cases, especially in elderly patients Surgical Treatment Surgery is the most effective solution for most patients, especially when ptosis interferes with vision. Blepharoplasty (Eyelid Lift Surgery)Removes excess skin and tightens eyelid muscles for better lift and appearanceOften combined with aesthetic procedures Levator Resection or AdvancementTightens the levator muscle to improve its ability to lift the eyelidIdeal for moderate to severe ptosis with good muscle function Frontalis SuspensionIn cases of poor levator function, connects the eyelid to the forehead muscles to assist lifting using a sling material Congenital Ptosis CorrectionTailored procedures performed in early childhood to prevent visual development issues All surgeries are performed by board-certified ophthalmologists and oculoplastic surgeons with experience in both functional and cosmetic outcomes. Recovery After Ptosis Surgery Most patients return to daily activities within 7 to 10 days Swelling and bruising typically subside in 2–3 weeks Final results are usually visible after 1 month Patients should avoid rubbing the eyes and follow post-op instructions carefully Related Services at Bangkok Eye Hospital We provide comprehensive care for patients with eyelid and vision conditions, including: Oculoplastic Surgery CenterFor cosmetic and functional eyelid procedures Comprehensive Eye Examination ClinicTo assess visual impact and underlying causes Neurological Eye EvaluationTo diagnose nerve-related ptosis or related symptoms Pediatric Eye ClinicSpecialized care for children with congenital ptosis Post-Surgical Follow-Up and Cosmetic CounselingEnsures safety, satisfaction, and long-term eyelid health Frequently Asked Questions (FAQs) Is ptosis only a cosmetic issue?No. While it can affect appearance, severe ptosis can interfere with vision and may indicate underlying health problems. Does ptosis get worse with age?Yes. Age-related ptosis tends to progress gradually due to muscle weakening and tissue sagging. Can children outgrow ptosis?No. Congenital ptosis requires early assessment and may need surgical correction to prevent vision problems. Is ptosis surgery painful?The procedure is typically performed under local anesthesia with mild sedation. Post-operative discomfort is minimal and manageable with medication. Can ptosis come back after surgery?Recurrence is rare but possible, especially if the underlying condition persists. Regular follow-up helps ensure lasting results.