Palpebral Ptosis: Types, Symptoms, Causes, Risk Factors, Diagnosis and Treatment

The drooping eyelids vary in severity and may be barely noticeable until the eye’s pupil, iris, and other parts are completely covered.

Also known as drooping eyelid or blepharoptosis, it is the abnormally low position of the upper eyelid.

If severe or not treated, palpebral Ptosis can cause other conditions, such as amblyopia (lazy eye) or astigmatism.


  • Congenital Ptosis: is present at birth and is usually due to the lack of development of the eyelid muscles called elevators.
  • Acquired Ptosis is the most common type, and it is usually because the muscles that raise the eyelid become weak, thin, or stretch with age.

Fallen eyelids interfere with vision and may cause fatigue due to efforts to elevate the eyelids. When congenital Ptosis affects visual development in children, surgery may be required to prevent the development of amblyopia.

Ptosis should also be differentiated from dermatochalasis, which is extra eyelid skin that can also cause the appearance of a drooping eyelid. The causes and treatment of dermatochalasis are very different from those of Ptosis.

What are the symptoms of palpebral Ptosis?

The most apparent symptom of Ptosis or blepharoptosis is the drooping eyelid itself. Other symptoms include difficulty opening the eye or the need to tilt the head back to see better. Eye fatigue, misaligned eyes, or double vision can also accompany Ptosis.

You or your doctor can compare a picture of you from ten years ago to a recent one to see if there is a difference in your eyelids.


What has caused my eyelid to fall?

The causes of palpebral Ptosis are diverse. One can be born with drooping hereditary eyelids, a condition known as congenital Ptosis. Most cases of acquired Ptosis develop as we get older, and the tendon that helps keep the open eyelid stretches and loosens.

Fallen eyelids can also be caused by trauma, surgery, or damage to the muscles that lift the eyelids or the nerves that control these muscles. It is also known that tumors, neurological disorders, systemic diseases, and certain medications cause Ptosis.

Depending on the cause, Ptosis can be classified as:

  • Neurogenic Ptosis: refers to the condition in which the nerves attached to the muscle are affected.
  • Myogenic Ptosis: refers to the flaccidity of the lid due to a problem with the power that lifts the eyelid.
  • Aponeurotic Ptosis: refers to the stretching and weakening of the tendon responsible for raising the eyelid.
  • Mechanical Ptosis: refers to a condition in which the weight of the eyelid is too large for the muscles to rise.

What risk factors am I facing with palpebral Ptosis?

A variety of factors can increase your risk of developing Ptosis. They include:

  • Aging.
  • Family history of Ptosis.
  • Birth injury
  • Ocular surgery such as cataract removal.
  • Paralysis of nerve fibers in the eyelids.
  • Diabetes.
  • Horner’s syndrome.
  • Head or eyelid trauma.
  • The tumor is cerebral.
  • Muscular dystrophy.
  • Myasthenia gravis.

How is palpebral ptosis diagnosed?

Your ophthalmologist will be able to diagnose Ptosis with an examination of your affected eyelid. They will ask you questions about your symptoms, family medical history, and personal history.

In some cases, medical tests are performed to determine the cause of the acquired Ptosis. Because there are several reasons why an eyelid may fall, it is highly recommended that you get a diagnosis from an eye doctor, even if the symptoms are mild.

What treatment options are there for my palpebral Ptosis?

If the symptoms of Ptosis are mild, treatment may not be necessary. The specific treatment is usually directed to the underlying cause.

Special glasses can be used in some cases; These glasses have a crutch attached to hold the eyelid. In moderate to severe cases, surgery may be the only option to correct the eyelid.

The most common surgery used to treat Ptosis is an advancement of the levator aponeurosis. The surgeon will tighten the elevator tendon, lifting the eyelids during this procedure.

Occasionally, as in cases of congenital Ptosis, the levator is too weak to open the eyelids; In this case, a “sling” is used to allow the forehead muscles to assume the task of lifting the eyelid.

Although they may not appear symmetrical, the eyelids will be taller than before surgery.

Bruising and usually swelling last two to three weeks. Most people heal without complications within six weeks of surgery. Usually, this is done as outpatient surgery, which means there is no hospitalization.