Droopy Eyelids: What Causes Them & Can They Be Treated? | Women's Eye Health & Safety Month

Droopy eyelids: They can make us look tired, even when we’re not, and they can add years to our appearance. Are they just a nuisance though?
 
Unfortunately, the answer is no.

​Sagging eyelids may affect more than our looks. In some cases, they can also affect our eye health and vision.

Signs of Droopy Eye Lids

Signs of droopy eyelids, which can affect one or both eyes, may be quite obvious or subtler. According to the American Academy of Ophthalmology, in some cases, sagging eyelids can be so severe that the eyelid droops over the pupil and blocks side vision. If sagging eyelids are blocking vision, certain activities like driving can become dangerous. Further, droopy eyelids can lead to dry and irritated eyes, since sagging eyelids don’t work as efficiently at keeping our eyes moist.

Causes of Droopy Eyelids

The medical term for droopy eyelids is ptosis, and it can have a few causes. The most common cause of sagging eyelids is aging. As we age, the levator muscle, which supports and lifts the eyelid, may start to stretch. As the muscle stretches, it can cause the eyelid to sag. In addition, the skin around the eyes may also lose its elasticity, which can contribute to drooping. This is called pseudoptosis or dermatochalasis. This type of droopy eyelids also worsens gradually over time.
 
Although aging is the most common cause, sagging eyelids can also be caused by an injury that affects the muscles or nerves that lift the eyelid. Certain neurological disorders, such as a stroke or an eye tumor affecting the nerve, may also lead to a drooping eyelid. 

Drooping Eyelids in Children

It’s important to note that although droopy eyelids are more common in adults, the condition can also occur in children. According to the American Association for Pediatric Ophthalmology and Strabismus, in most cases, when children have droopy eyelids, it is due to a congenital abnormality. The levator muscle may not develop properly, which results in sagging eyelids. The reason why some children are born with the congenital abnormality is not known. In addition to a congenital abnormality, some kids can also develop the condition due to an injury to the levator muscle. It is important to recognize this condition as it can lead to amblyopia, commonly referred to as a “lazy eye”.
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Treating Droopy Eyelids

If droopy eyelids are not interfering with vision, treatment may still be performed for cosmetic reasons to improve appearance. The type of treatment recommended may depend on the severity of the sagging.
 
According to the American Society for Dermatologic Surgery, many techniques to treat droopy eyelids are performed with only a local anesthetic and do not require much downtime during recovery. Treatment options include:
 
Laser Resurfacing:
Laser resurfacing may be an option for people who do not want to have surgery. The procedure involves using a laser to remove old skin cells and tighten the skin around the eyes. Using a laser allows the doctor to have precise control over the area, including the depth of treatment. Laser resurfacing for droopy eyelids typically works best in cases where the sagging is minor. Possible risks include swelling, pain, and bruising.
 
Surgery:
There are a couple of different surgical procedures that help treat droopy eyelids. A brow lift is one option. A brow lift corrects sagging upper eyelids, as well as sagging eyebrows and forehead skin. A brow lift may be a good choice for people who also have forehead wrinkles along with eyelid drooping.
 
Blepharoplasty is another surgical procedure used to treat droopy eyelids caused by dermatochalasis. During the procedure, the excess skin is removed from the upper eyelid. In true ptosis repair, the levator muscle that supports the eyelid is also lifted. In some cases, only a small adjustment is enough to lift the muscle. In severe cases of eyelid sagging, the levator muscle is also strengthened, which helps it function more effectively.
 
Usually, blepharoplasty can be performed on an outpatient basis with only local anesthesia, which means you are awake for the procedure. Risks of the surgery may include dry eyes, swelling, and blurred vision, which is temporary. Typically, swelling and bruising clear up after about two weeks. 
 
As with any surgery, it’s important to discuss the risks versus the benefits of the procedure. Depending on the severity of the sagging and your underlying health, certain treatments may not be recommended. 

Preventing Droopy Eyelids

While preventing droopy eyelids may not be possible, taking measures to protect your eyes and the skin around your eyes – early, before the affects of aging start to set in – can help. Check with your eye doctor for safe moisturizers for your eyes. Be sure to wear sunglasses with 100% UV protection when you’re outside, and wear a hat for further protection from the sun’s rays. If recommended by your eye doctor, you may also try an eye cream with UV protection for daily use, as UV rays can reach your eyes even behind glass in your home or car.
 
Droopy eyelids may not seem like a serious condition, but they can affect a person’s self-image and possibly their vision. Fortunately, there are treatment options that are often effective and steps that you can take to protect your eyelids. If you have any questions or would like to schedule an appointment with our oculoplastic surgeon, Dr. David Chen, please call our office at 508-746-8600.
 
We hope you have enjoyed our post this week. Please check back with us for our last post for Women's Eye Health and Safety Month, as we cover “Makeup and Eye Health.” Thanks for reading!