It is only a problem when the eyes are in a relaxed,rested gaze, and some of the pupil is being blocked... other than that, if the eyelid crease lies above the pupil in a resting gaze, than there is no cause of concern besides cosmetic? Or could such a small degree of ptosis cause unnecessary eye strain?
When is Ptosis a Problem?
Doctor Answers 4
Drooping eyelid is a common condition
The upper eyelid is the one that primarily moves. There is one muscle that opens the eyelid, kind of like a garage door opener. Some people are born with a weak muscle, most of us will develope it over time. Most doctors will recommend treating it when the eyelid comes down to, or begins to block the pupil( the dark circle in the middle of the eye). I have had some patients request correction because of cosmetic reasons before the lid settles to that point.
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Mild ptosis of the eyelid may not cause a problem. If you have vision issues then you may want to fix it.
Eyelid ptosis a problem when it affects vision
Droop of an upper eyelid, or ptosis, is a problem when it affects vision. Often the effect is very subtle and can be noticed as a loss of the upper field of vision. Overhead stoplights and signs may become more difficult to see as the lid encroaches on the pupil. The impact can be measured with a visual field test which will determine if the lid ptosis is indeed a medical problem.
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When is ptosis a problem?
It is usually a problem if more than just a small sliver of cornea is covered by the lid margin in a relaxed straight ahead gaze (more than 1mm). This can certainly cause eye strain, eyelid heaviness, recruitment of the forehead muscle to help keep the eyes open. Some patients experience early ptosis only on downgaze such as while reading. It sometimes takes an experienced ophthalmic plastic surgeon to tease all this out.