Do I Have Ptosis or Just "Hooded Lids?"

Question

I have always had "droopy eyelids" from birth. I am a 27 year old caucasion female and it seems that it is getting worse. I'm not sure if I just have a "hooded lid" or actual ptosis. If so, is this something i'll need to have corrected? I have astigmatism in both of my eyes extremely bad. Not sure if that has anything to do with it.

Manish H. Shah, MD, FACS · Answer

Hello,

	I would recommend that you go see an Ophthalmologist or an Oculoplastic Surgeon to have your complaints addressed.  Without seeing a picture of your eyes, you may have congenital ptosis.  If you feel that your looks are hindered, or you are having visual difficulties, I would recommend that you seek consultation.  There are relatively low risk operations to manage ptosis vs. "hooded skin."

	Good luck,

	Dr. Shah

Lawrence Kass, MD · Answer

No way to answer this question without seeing photos.  Try resubmitting with photos for the best help!

Donald M. Brown, MD · Answer

Without photos it is not possible to determine whether you have just extra skin or in fact ptosis.

	 Does this really matter?

	If you are not happy with the appearance of your eyes you should have a consultation with a board certified plastic surgeon, facial plastic surgeon or oculoplastic surgeon.  Have them examine you and tell you what the problem is and explain what  can be done to improve it.

	 Good luck.

	 Dr. Donald Brown.

Von Graham, MD · Answer

I don't see any pictures with this question which would make it easier to answer. That being said, in general you need to look at the upper third of the face as a whole. Your issue could be brow ptosis, lid psuedo-ptosis, or true ptosis. At your young age the chance of brow ptosis is less though I have seen it in young individuals as an inherited feature. Psuedoptosis is hooding of the upper lid where the lid margin(area with the lashes) is in a normal position. True ptosis involves a problem with the deeper muscles of the eye causing the lid margin itself to drop down in an abnormal position. Both problems can cause visual field impairment. Again, photos would help in diagnosis.

Andrea Nowonty Hass, MD · Answer

Hooding refers to the amount of skin on your lids, and when significant it can sit on and over the lashes. Ptosis refers to a droopy lid, which refers to where the edge of the upper lid sits against the eyeball. A normal lid sits at or just below the top of the iris such that no white shows above the colored part of the eye.

	We'd best be able to give you an answer from a photo, but here are a couple of clues: If you can pinch a lot of shkin, and in lifting it off your lids your eyes look nice and open, then you most likely have just hooding. If when you lift the skin up you still see that your lid margin is close to your pupil (the black center in the middle of the colored part of your eye), then you may actually have some ptosis. Either way, both can be addressed with eyelid surgery.

Rafael C. Cabrera, MD · Answer

there is no picture to help with the diagnosis. congenital ptosis is quite different from blepharochalasis, there is no way to help you with the limited information you provided.

Francis R. Palmer, III, MD (retired) · Answer

I'd need to see a picture of your eyes and eyelids to decide if it's ptrue eyelid ptosis or excess upper eyelid skin which seems unlikely for a 27 year old male, but not imposssible.

Do I Have Ptosis or Just "Hooded Lids?"

Answers (7)

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