Ptosis Surgery. My ptosis tends to get worse as the day goes on. Will this affect the outcome of surgery?

I am scheduled to get ptosis surgery in a few weeks. My ptosis tends to get worse as the day goes on with it being much worse at night. Because it is so variable through the day/night will it affect the outcome of surgery? When I wake up in the mornings there is only a very slight ptosis and as the day goes on it gets worse and my eyelid feels heavier and heavier. My Doctor does not seem to be concerned about this but online I have found differing opinions.

Doctor Answers 3

Fluctuating ptosis

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is not uncommon for age-related ptosis to worsen later in the day but it would be best to evaluate for myasthenia gravis as the others have suggested since this can be a serious neurological condition. Discuss it with your surgeon.

Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Most people with what we call involutional ptosis may notice a worsening of the lid height as the day goes on.  The levator muscle and the forehead work hard throughout the day to elevate the lid, and by night the lid may start to fall more.  There is a disease called myasthenia gravis where this is very pronounced.  This should be ruled out before your surgery.  There are specific tests that can be done by the surgeon.  Make sure you see an oculoplastic surgeon to rule this out.   

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hi there, thank you for your interesting question.

There is a medical condition called myasthenia gravis - has this been excluded in your case?  If you definitely do not have this condition, nor hypothyroidism, then I do not believe that progressive worsening of your ptosis over the day will likely alter the surgical outcome.

The key is this:  What is the diagnosis?  Ptosis is a description, not a condition.  There is a cause. So, the cause being correctly diagnosed will provide the answer to your question.

If you're not sure of the underlying cause of the ptosis, please visit your doctor and ensure that you have it all explained to you.

I hope this helps,

Howard Webster
Plastic Surgeon.

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.