Eyelid ptosis, or 'droopy lid' usually occurs in adults as a result of dysfunction of the muscle that lifts the lid. Eyelid ptosis can also be congenital or affect younger adult patients as a result of contact lens wear which traumatises the levator muscle as it inserts into the eyelid. There are also a range of neurological conditions that can cause ptosis. Ptosis can cause aesthetic problems giving the appearance of a tired look and can also cause visual problems if the eyelid is unable to clear the visual axis.
The type of treatment offered depends on many factors, and will often involve a hidden incision in the natural skin crease of the upper eyelid. Ptosis surgery can also be performed through the underside of the eyelid forgoing the need for a skin incision. The key step in the procedure is the identification of the muscle controlling the lifting of the eyelid, which is then advanced and reattached to the lid. In other rarer forms of ptosis, a suspension to the brow is performed, whereby the lifting of the brow region is mechanically coupled to the eyelid.
Other non-surgical treatments are also available and have their role in the treatment of ptosis and these include botulinum toxin, ptosis props which are attached to glasses and also specialised contact lenses to hold up the eyelid. Ptosis surgery is also commonly performed with upper eyelid blepharoplasty to provide an optimal appearance of the upper eyelid and to improve vision.