Ptosis is the medical term for drooping of the upper eyelid, a condition which may affect one or both eyes. Ptosis may be congenital or acquired. When the edge of the upper eyelid droops, it may block the upper field of vision. The normal position of the upper eyelid is midway between the top of the cornea (the clear part of the front of the eye) and the top of the pupil.

Symptoms of ptosis include a decreased ability to keep the eyes open, eye strain and eyebrow fatigue from increased effort needed to raise the eyelids, especially when reading.

In severe cases, it may be necessary to tilt the head back or lift the eyelid with a finger in order to see out from under the drooping eyelid(s). Patients may also note that their eyes have a tired appearance from "drooping eyelids" even though they are well rested.

There are a variety of classifications and causes of ptosis, and the correct diagnosis is critical for proper treatment. For instance, congenital ptosis (ptosis present at birth) is due to an abnormality of the levator eyelid muscle which prevents this muscle from contracting and elevating the eyelid. Acquired ptosis (ptosis which develops later in life) may be due to one of several causes. It may represent a symptom of a systemic problem (e.g. myasthenia gravis), or it may be the normal result of aging. Other causes of ptosis include trauma, excess upper eyelid skin (dermatochalsis), and neurologic abnormality.

Treatment of ptosis, with the exception of myasthenia gravis, is surgical. In children, surgery can be performed once accurate measurements are made and the child is able to cooperative postoperatively. Astigmatism and myopia (near sightedness) may be associated with childhood ptosis; if severe, permanent loss of vision may occur if the eyelid is not raised. Most ptosis operations involve surgery on the levator muscle (one of the muscle that elevates the eyelids). Symmetry is the goal of surgery.

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