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What is ptosis?
Ptosis (also called blepharoptosis) is the medical term for drooping of the upper eyelid. A drooping eyelid can affect one or both eyes. While the cause is often harmless and age-related, in some cases it may indicate an underlying medical condition that requires further assessment.
It can partially or completely cover the pupil and, in more advanced cases, interfere with vision. Some patients describe a heavy eyelid, visual tiredness or increasing difficulty seeing clearly, particularly towards the end of the day.
Many patients delay seeking advice because they assume nothing can be done or that treatment is complex. In reality, ptosis surgery is a commonly performed and highly specialised procedure when carried out by an experienced oculoplastic surgeon.
In some cases, the brow may also droop. This is known as brow ptosis and can occur alongside or separately from eyelid drooping.
What can look similar to ptosis?
Not all drooping around the eyes is true ptosis. Several conditions can create a similar appearance, and careful assessment is important to determine the correct diagnosis.
Dermatochalasis
This refers to excess upper eyelid skin that hangs over the lid margin and can give the appearance of a droopy eyelid. Treatment typically involves removal of excess skin and reshaping of the eyelid crease, a procedure known as blepharoplasty.
Brow ptosis
A low or descended eyebrow can contribute to upper eyelid heaviness and excess skin. In some patients, a brow lift combined with blepharoplasty provides the most balanced and natural result.
Enophthalmos
In this less common condition, the eye sits further back in the socket, creating the impression of eyelid drooping. It may be related to previous trauma, congenital factors or other rare causes.
Symptoms of ptosis
Ptosis affects more than appearance. Common symptoms include:
- Difficulty keeping the eyes open
- Eye strain or tiredness when reading
- Aching around the eyebrows or forehead
- Fatigue during tasks that require focus
These symptoms usually develop gradually in long-term cases, such as age-related or contact lens-related ptosis.
You should seek urgent medical assessment if ptosis develops suddenly or is associated with:
- Double vision
- Severe headache
- A noticeable change in pupil size
- General weakness
- Eye pain
These symptoms can indicate an underlying neurological cause and require prompt evaluation.
What causes ptosis?
Ptosis can be present from birth (congenital) or develop later in life (acquired).
Congenital ptosis usually happens when the muscle that lifts the eyelid (levator muscle) doesn’t develop properly. It may affect one or both eyes.
Acquired ptosis (ptosis that appears later in life) is often caused by ageing, long-term contact lens wear, previous eye surgery or swelling that stretches or weakens the eyelid muscle.
Less commonly, ptosis may be linked to neuromuscular conditions such as myasthenia gravis or myotonic dystrophy, which can cause drooping eyelids and changes in facial movement.
Diagnosing ptosis with London Oculoplastics
Diagnosis begins with a detailed consultation and examination to understand how and when the eyelid drooping began. Old photographs can be helpful to see if the change has developed gradually or has been present for many years.
Most cases can be diagnosed through a clinical examination and a review of your medical history. In some cases, further tests such as an orthoptic (eye movement) assessment or pupil test may be recommended.
Occasionally, blood tests, computerised tomography (CT) scan or magnetic resonance imaging (MRI) scans are arranged to rule out underlying neurological conditions or rare progressive muscular disorders.
These include:
- Myasthenia gravis
- Horner’s syndrome
- Third cranial nerve palsy
- Chronic progressive external ophthalmoplegia (CPEO)
These conditions require specialist assessment and, in some cases, wider neurological investigation.
Ptosis treatment options
Treatment depends on the type and severity of ptosis and how well the eyelid muscles function. The first step is to identify the cause, as this guides the most effective approach.
Why choose London Oculoplastics for your ptosis treatment?
Your care is led by Mr Jimmy Uddin, consultant oculoplastic surgeon at Moorfields Eye Hospital, with over 25 years of experience treating all forms of ptosis.
Patients from the UK and overseas trust London Oculoplastics for:
- Specialist expertise in eyelid surgery
- Personalised treatment and natural results
- Safe, precise techniques with minimal scarring
- Continuity of care throughout your treatment
Paying for your ptosis treatment in London
We welcome self-paying and insured patients. Following your consultation, a clear and transparent quote will be provided before any treatment begins.
For more information about fees or to request a guide price, please contact our team.
Access ptosis treatment in London
We welcome self-paying and insured patients. Following your consultation, a clear and transparent quote will be provided before any treatment begins.
For more information about fees or to request a guide price, please contact our team.
Ptosis frequently asked questions (FAQs)
Contact us
Moorfields Private Outpatient Centre
London (Central London)
Moorfields Private Practice
London (Central London)
Parkside Hospital