Drooping Eyelids
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Drooping eyelids
Droopy eyelid
Ptosis
About the Symptom
Ptosis is drooping of the upper eyelid. This may block vision. It can be caused by weak eyelid muscles or by eyelid swelling.
When to See a Doctor
Seek professional care if you experience any of the following symptoms
- Blurring of vision
- double vision
- Recent weight loss
- Impossible to walk normally
- Fever
- Slurred speech
- Unilateral blindness
- Dysphagia
- Disorder of consciousness
- Abnormal sensation (tingling, prickling)
- Involuntary movements
- History of cerebrovascular disorder
- Eye movement disorder
- Easy fatiguability
- Headache
- Altered mental status (delirium)
- Muscle weakness in the limbs
- Eye pain
- Photophobia
- Visual field defect
- Numbness / sensory disorder
Possible Causes
Generally, Drooping eyelids can be related to:
- Tolosa Hunt Syndrome
Tolosa-Hunt Syndrome is a rare condition characterized by severe headaches behind the eyes, decreased and painful eye movements typically in just one eye. The exact cause is unknown, but it may be related to inflammation in certain areas behind the eye.
- Myasthenia Gravis
Myasthenia gravis (MG) is a condition characterized by the immune system producing abnormal antibodies that block muscles from receiving nerve signals. This results in muscle weakness and easy fatigue, as well as double vision, drooping eyelids, facial weakness or hoarseness.
- Lambert-Eaton Syndrome
Lambert-Eaton syndrome is a condition where a person's immune system attacks the connections between the nerves and the muscles. This usually causes muscle weakness and fatigue. This condition is most often seen in people with small cell lung cancer, those with immune system problems, or rarely other types of cancer such as lymphoma.
- Unruptured Cerebral Aneurysm
- Cluster Headache
- Muscular Dystrophy
- Mediastinal Tumor
Related Serious Diseases
Sometimes, Drooping eyelids may be related to these serious diseases:
- Guillain-Barre Syndrome (GBS)
Guillain-Barre syndrome (GBS) is a rare nerve disorder where a person's own immune system attacks their nerves. GBS can cause symptoms ranging from mild (arm/leg numbness or weakness) to severe and life-threatening (inability to breathe, abnormal heart rhythm, very high/low blood pressure). The prognosis is generally good. Over half of people fully recover and 80% can walk independently at 1 year. However, a minority of people may have permanent nerve damage or need a ventilator to breathe, and the overall death rate ranges from 3% to 7%.
- Cerebral Infarction
Doctor's Diagnostic Questions
Your doctor may ask these questions to check for this symptom:
- Have you been experiencing drooping of your eyelids?
- When did you first notice the drooping eyelids?
- How often do you experience drooping eyelids?
- How are your drooping eyelids now?
- Which of the following best describes how your drooping eyelids appeared?
Reviewed By:
Bret Mobley, MD, MS (Neuropathology)
Dr. Mobley graduated from the University of Michigan Medical School, completing a masters degree in neuroscience between his second and third years of medical school. He trained as a resident in pathology at Stanford University Hospital before joining the faculty of Vanderbilt University Medical Center in Nashville Tennessee in 2010. He was promoted to Associate Professor in 2018 and to Neuropathology Division Director in 2020.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Feb 6, 2025
Following the Medical Content Editorial Policy
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- Drooping of the upper eyelid over the eye
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FAQs
Q.
Is it Ptosis? Why Your Eye is Sagging & Medically Approved Next Steps
A.
Ptosis is a drooping upper eyelid, most often age related and not dangerous, but a new or worsening droop that blocks vision or appears with double vision, severe headache, weakness, trouble speaking, or in a child needs prompt medical evaluation. Medically approved next steps vary by cause and severity, from watchful waiting and treating underlying issues to highly effective outpatient surgery when vision is affected; there are several factors to consider, so see below for complete red flags, diagnosis, and the right steps to take.
References:
* Cogen MS, et al. Ptosis: A Clinical Overview. J AAPOS. 2018 Oct;22(5):333-339.e1. doi: 10.1016/j.jaapos.2018.06.002. Epub 2018 Aug 29. PMID: 30171922.
* Shrestha B, et al. Acquired Ptosis: Etiology, Diagnosis, and Management. Semin Plast Surg. 2023 Feb;37(1):61-68. doi: 10.1055/s-0043-1761616. Epub 2023 Feb 15. PMID: 36796677.
* Vangaveti V, et al. Congenital ptosis: An update on evaluation and management. Oman J Ophthalmol. 2021 Jan-Apr;14(1):2-8. doi: 10.4103/ojo.ojo_199_20. Epub 2021 Mar 4. PMID: 34084177. PMCID: PMC8172935.
* Glavas IP, et al. Current Surgical Management of Ptosis. Middle East Afr J Ophthalmol. 2020 Jan-Mar;27(1):1-7. doi: 10.4103/meajo.MEJO_21_20. PMID: 32256860. PMCID: PMC7092925.
* Chu YR, et al. Evaluation and Management of Ptosis. Curr Opin Ophthalmol. 2023 Nov 1;34(6):534-540. doi: 10.1097/ICU.0000000000000962. PMID: 37707474.
Q.
Constantly Looking Tired? Why Eyelids Sag & Medical Blepharoplasty Next Steps
A.
Sagging eyelids can stem from normal aging, excess skin called dermatochalasis, true muscle droop known as ptosis, or less commonly neurological disease, and they may make you look fatigued or even block vision. If your lids impair reading, driving, or force brow lifting, an eye exam and possible medical blepharoplasty could restore function; sudden drooping with double vision, weakness, or trouble speaking needs emergency care. There are several factors to consider. See below for the full guide on symptoms, visual field testing and insurance requirements, procedure types, risks, recovery timelines, and non-surgical options to help choose your next step.
References:
* Bernardini F, Salvi R, Di Taranto G, Santorelli A. Dermatochalasis: A Review of the Pathophysiology, Presentation, and Management. Graefes Arch Clin Exp Ophthalmol. 2021 Apr;259(4):889-900. doi: 10.1007/s00406-020-01201-3. PMID: 33496884.
* Mukkamala B, Mukkamala SK. Eyelid Ptosis: Causes, Diagnosis, and Management. Indian J Ophthalmol. 2022 Mar;70(3):729-738. doi: 10.4103/ijo.IJO_106_22. PMID: 35439704.
* Most S, Cohen JM. Functional Blepharoplasty: A Review of Current Concepts. Plast Reconstr Surg. 2020 Apr;145(4):781e-790e. doi: 10.1097/PRS.0000000000008585. PMID: 32210870.
* Patel S, Dhandha MM, Veldman P. Management of dermatochalasis and blepharoptosis. Curr Opin Ophthalmol. 2022 Mar 1;33(2):161-167. doi: 10.1097/ICU.0000000000000843. PMID: 35133642.
* Iordache F, Enache A, Hâncu R, Diaconu G, Bălălău C, Bratu M, Zgura C, Vîlcea ID, Neacșu C. Upper Blepharoplasty: When Is It Functional? A Literature Review. Aesthetic Plast Surg. 2024 Feb;48(1):340-346. doi: 10.1007/s00266-023-00971-1. PMID: 38227653.
Q.
Droopy Eyelids at Parties? The Social Symptom You're Ignoring
A.
Sudden eyelid drooping that appears during laughter, excitement, or social engagement can signal mild cataplexy, often associated with narcolepsy type 1, and it differs from fatigue-related ptosis that develops gradually and improves with rest. There are several factors to consider, including your trigger patterns, daytime sleepiness, and any accompanying weakness or vision changes; track episodes, consider an online symptom check, and talk with a clinician about evaluation and treatment such as sleep studies and targeted medications. See below for complete guidance and red flags that may require urgent care, which could change your next steps.
References:
* Li H, Wang X, Zhang S, Hu J, Sun Y, Wang Y. Impact of Blepharoptosis on Quality of Life and Visual Function: A Systematic Review. J Ophthalmol. 2023 Jan 3;2023:6690412. doi: 10.1155/2023/6690412. PMID: 36622300; PMCID: PMC9832707.
* Ramakrishnan V, Shahi V, Madan M, Jain A, Singh S, Agrawal C. Psychological impact of ptosis on adolescents and young adults. J Clin Ophthalmol Res. 2021 Jul-Sep;9(3):148-151. doi: 10.4103/jcor.jcor_107_21. Epub 2022 Jan 4. PMID: 35002046; PMCID: PMC8746772.
* Ong S, Khazaei H, Chee E, Tan K, Lim T. The psychosocial impact of congenital ptosis and its surgical correction: a qualitative study. Br J Ophthalmol. 2018 Jun;102(6):734-738. doi: 10.1136/bjophthalmol-2017-310899. Epub 2018 Mar 20. PMID: 29555627.
* McCord CD Jr, Doxanas MT. Impact of surgical correction of ptosis on visual function and quality of life. Ophthalmic Plast Reconstr Surg. 2011 Oct;27 Suppl 1:S1-S6. doi: 10.1097/IOP.0b013e3182390219. PMID: 21976939.
* Kersten RC, Patel P, Kulwin DR, Wulc AE, Biesman BS, Lemke BN, Lelli GJ Jr, Lee WW, Kikkawa DO, Members of the ASOPRS PSIS Study Group. Patient-reported outcomes following surgical correction of ptosis. Ophthalmic Plast Reconstr Surg. 2013 May-Jun;29(3):184-7. doi: 10.1097/IOP.0b013e318288591a. PMID: 23619520.
Q.
Droopy Eyelids During Joy? The Subtle Sign of Cataplexy in Social Life
A.
Droopy eyelids that happen right when you laugh, feel excited, or see someone you love can signal mild cataplexy, a brief emotion-triggered loss of muscle tone that often accompanies narcolepsy type 1, with episodes lasting seconds and full awareness preserved. There are several factors to consider; see details below on look-alike conditions to rule out, key narcolepsy symptoms, when to seek urgent care, and the evaluation and treatment options that can shape your next steps.
References:
* Sartori P, Barbagallo G, Boscolo-Rizzo V, Mestriner C, Bortolotti P, Cagnin A, Rossi F. Facial cataplexy in narcolepsy type 1. Sleep Med. 2017 Mar;31:175-176. doi: 10.1016/j.sleep.2016.12.016. Epub 2016 Dec 21. PMID: 28212952.
* Dauvilliers Y, Arnulf I, Mignot E. Partial cataplexy: a diagnostic challenge. Curr Neurol Neurosci Rep. 2007 Mar;7(2):162-8. doi: 10.1007/s11910-007-0026-6. PMID: 17316499.
* Bassetti CL, Vella S, Donati F, Wielepp P, Weder B. The emotional trigger of cataplexy. Ann Neurol. 1996 Dec;40(6):928-31. doi: 10.1002/ana.410400619. PMID: 8981903.
* Pizza F, Ambrosi C, Vandi S, Moresco M, Mignot E, Plazzi G. Narcolepsy with cataplexy: a review of current knowledge. Brain Res. 2013 Aug 16;1529:3-19. doi: 10.1016/j.brainres.2013.04.053. Epub 2013 May 2. PMID: 23648430.
* Shimono K, Tanaka S, Hiyama T, Hato N, Nishino S, Tanaka M, Fujiki Y, Tanaka K, Nishizaki K, Okawa M. Clinical significance of partial cataplexy: a reappraisal of the diagnostic criteria. J Clin Sleep Med. 2011 Dec 15;7(6):629-32. doi: 10.5664/jcsm.1444. PMID: 22163351; PMCID: PMC3234399.
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