Eyelid drooping

• Considerations

  A drooping eyelid can stay constant, worsen over time (progressive), or come and go (intermittent). It can be one-sided or on both sides. When drooping is one-sided (unilateral), it is easy to detect by comparing the two eyelids. Drooping is more difficult to detect when it occurs on both sides, or if there is only a slight problem.

  A furrowed forehead or a chin-up head position may indicate that someone is trying to see under their drooping lids. Eyelid drooping can make someone appear sleepy or tired.

  Drooping lids are either present at birth (congenital) or develop later in life. A drooping eyelid is not a reason to panic, but you should report it to your doctor.

• Common Causes

  Both eyelids drooping:

  • Medical problem, such as myasthenia gravis
  • Migraine headaches
  • Normal aging process
  • Normal variation of the eyelids

  One eyelid drooping:

  • Growth in the eyelid, such as a stye
  • Medical problem
  • Nerve injury
  • Normal aging process
  • Normal variation
• Home Care

  Below is a list of recommendations based on the various causes of eye drooping:

  • Caused by aging -- no treatment is necessary, unless it affects your vision.
  • Caused by an allergic reaction -- consult your doctor about antihistamine or steroid treatment.
  • Caused by nerve injury -- consult your doctor about surgical correction.

  For all other causes -- follow your health care provider's recommendations.

• Call your health care provider if

  Contact your health care provider if:

  • Eyelid drooping is affecting your appearance or vision
  • One eyelid suddenly droops or closes
  • It is associated with other symptoms, such as double vision
• What to expect at your health care provider's office

  Your health care provider will get a medical history and perform a physical examination.

  Medical history questions may include:

  • Are both eyelids affected or just one?
  • How long has this been present?
  • Is it getting worse or staying the same?
  • Is it present all of the time or only sometimes?
  • What other symptoms do you have?

  The physical examination may include a detailed assessment of nerve functioning.

  Diagnostic tests that may be performed include:

  • Slit-lamp examination
  • Tensilon test

  Interventions:

  Surgery may be necessary to correct problems with the muscles that open the eyelid (levator muscle dysfunction).

  You may get special spectacle frames that suspend the eyelid by traction with a wire. Usually these frames help patients with temporary, partial paralysis, or those who are not good candidates for surgery.

  After seeing your health care provider:

  You may want to add a diagnosis related to eyelid drooping to your personal medical record.

• References

  Custer PL. Blepharoptosis. In: Yanoff M, Duker JS, Augsburger JJ, et al, eds. Ophthalmology. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004: chap 86.

Review Date: 11/10/2008

Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.