If I had Congenital eyelid ptosis, wouldn't my Optometrist have diagnosed by now?

I posted a picture of my eyes on here and doctor said I may have congenital eyelid ptosis. If I did have that wouldn't it have been found bc I wear glasses so I have been to a Optometrist for eye check ups for my sight. Also my eyelids have been they way they are since I was born and I'm 20 now.
Is it considered a normal thing to be born with? Is it common for babies to be born with it if it doesn't effect there vision?

Is the cost for this surgery covered by health insurance? What if u have congenital eyelid ptosis but it doesn't affect your vision would it be covered?

Doctor Answers 6

You do not appear to have congenital ptosis

U do appear to have congenital ptosis.  If it obstructs your superior and lateral visual fields then your insurance network may cover the surgery to correct this.  Even though you have functions quite well up to this point in your life it will likely progress necessitating surgery eventually.  Consult with an oculoplastic surgeon.

Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Eyelid ptosis

Dear Sandra
I recommend that you see a board certified plastic surgeon or opthamologic plastic surgeon to determine whether you actually have eyelid ptosis.  Your pictures don't show enough to make any diagnosis.  A plastic surgeon meeds to examine you personally to determine exactly how much eyelid drooping is present and whether it is bilateral.  Also the surgeon needs to see you to determine the strength of the muscle that lifts your eyelids and whether you would benefit from any surgery.
Of course, your optometrist is not qualified to diagnose or deal with these problems. 

John M. Griffin, MD (retired)
Atlanta Plastic Surgeon
5.0 out of 5 stars 5 reviews

Congential ptosis

if you have had this appearance since birth then you have a congenital ptosis.  For children who have ptosis, it is important to have the lid height evaluated at a young age.  If the lid is covering the pupil, the sight will not develop normally, and they will need surgery.  If you lids are above the pupil and you do not have any visual issues then it can be done at a later age.  An optometrist may notice that the lids are low, but they are not medical doctors or surgeons and if it is not bothering you, they may not refer you to an appropriate specialist.  You should see an oculoplastic surgeon who can check your lid height and evaluate the muscle function to decide what surgery might be best if you wish to do that.     

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

Optometrists are great for what they are trained for.

However the are not eye M.D.s.  They never went to medical school.  In their training, they primarily work with healthy eyes needing refraction or glasses, contact lens fitting.  They are exposed to limited information on oculoplastic surgery.  Unfortunately in some healthcare systems, they may be the only eye care person you see unless you actually have a medical issue.  It is not realistic to hold them to the same standard as an ophthalmologist.  Ask for your primary care physician for a referral to an oculoplastic consultant.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews


Hi Sandra 782: your photos aren't posted with this question, so I can't comment on the diagnosis.  Congenital eyelid ptosis is not "normal" or all that common, but it certainly does happen.  To be clear, ptosis means "low" and you can have eyelid or brow ptosis.  Eyelid ptosis should not affect your vision unless the eyelid is so low that it covers your pupil or blocks your peripheral vision.  In other words, eyelid ptosis doesn't change the way your eyeball functions or "focuses on" the world around you.  It won't make you need contacts or glasses, and won't change the results of the eye exam an optometrist does.  An ophthalmologist (MD that takes care of eyes) would be more likely than an optometrist to notice and comment on eyelid ptosis. 

The surgery is sometimes covered by insurance.  It is more likely to be covered if it is blocking some of your vision. The test to determine that is called a visual field test, or Goldmann visual field test.  This can be done at an ophthalmologist's office.  If it isn't blocking your vision, your insurance may consider it cosmetic.  It can usually be repaired with a 20 minute procedure that can even sometimes be done right in the office.  Best of luck. 

Garrett Griffin, MD
Minneapolis Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Congenital eyelid ptosis

  • An optometrist fitting you for glasses would not necessarily diagnose congenital ptosis.
  • Congenital ptosis is uncommon but known to occur.
  • If you need surgery, your insurance company will be able to tell you correction is covered.
  • Now that Obamacare requires insurers to pay for preventive care in normal people, insurance companies are paying less for non-emergent medical conditions. Your insurer will be able to tell you what criteria you must meet to be considered insurance-eligible for surgery. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.