Age 22 - Can Drooping Left Eyelid Be Fixed?

Drooping eyelids in the older population is very common and is called Ptosis (the P is silent!)   Generally it occurs because the muscle (levator muscle) and its tendon (levator aponeurosis) stretch and thin with time and slip from their natural insertion positions.  Generaly the muscle itself is very healthy and just needs to be reinserted to the appropriate positions with a simple procedure.  

Other times, children are born with a droopy eyelid because the eye muscle doesn't develop correctly and requires a procedure to elevate it.  In this case the muscle is weak from birth and does not really change position.

In both of the above conditions the eyelid is ALWAYS droopy.  An eyelid that becomes droopy only occasionaly may even be a hallmark of something else, rarely a condition that is called myasthenia gravis, a neuromuscular disorder that causes the muscles to tire out easily.  It is often treated with medications.   Now, as I said this is very rare and you probably don't have this but it may be worthwhile to have some blood work or testing to make sure.   You fall into an unusual age range to have this problem unless you were born with some weakness that you may be able to see in old photographs of yourself. 

If there is no other reason that is causing your variable ptosis, then hopefull you too may be a candidate for ptosis surgery.

Good luck,

Jasmine Mohadjer, MD
Oculoplastic Surgeon

Best to see a boarded plastic surgeon in person to examine your eyelid issue. Over the internet very difficult to give accurate info.Droopy eyelid is PTOSIS (from Greek Ptosis or πτῶσις, to "fall") is a (drooping) of the upper or lower eyelid. The drooping may be worse after being awake longer, when the individual's muscles are tired. This condition is sometimes called "lazy eye". Classification is as follows:
Neurogenic ptosis which includes oculomotor nerve palsy, Horner's Syndrome, Marcus Gunn jaw winking syndrome, IIIrd cranial nerve misdirection.
Myogenic ptosis which includes myasthenia gravis, myotonic dystrophy, ocular myopathy, simple congenital ptosis, blepharophimosis syndrome
Aponeurotic ptosis which may be involutional or post-operative.
Mechanical ptosis which occurs due to edema or tumors of the upper lid
Neurotoxic ptosis which is a classic symptom of envenomation[9] by elapids such as cobras,[10] or kraits.[11] Bilateral ptosis is usually accompanied by diplopia, dysphagia and/or progressive muscular paralysis. Regardless, neurotoxic ptosis is a precursor to respiratory failure and eventual suffocation caused by complete paralysis of the thoracic diaphragm. It is therefore a medical emergency and immediate treatment is required.
pseudo ptosis due to:1-Lack of lid support:Empty socket or atrophic globe. 2-Higher lid position on the other side:

So you see to understand your ptosis leads to the correct tretment.

Best from MIAMI Dr. Darryl J. Blinski

Dear Fresno, you are describing one eyelid that becomes more droopy as the day goes along.  Many times the other eyelid is also affected, but less noticeable.

• Before undergoing a surgery though, several medical causes for droopy eyelids (such as myasthenia gravis) should be investigated by your doctor.  
• You need to be seen and examined by a Facial Plastic Surgery, Ophthalmologist, or Plastic Surgeon who may get your primary care doctor involved.
• If those causes are ruled out, then you can proceed with a ptosis repar.  

Eyelid ptosis repair can be very effective, but sometimes requires treatment to both eyelids. 

Best Wishes

Ptosis ("toe-sis") is a drooping of the eyelid due to a weakness of the eyelid muscle. Ptosis surgery is very technical and requires great precision to have a natural, beautiful outcome.  This is one of the most common surgeries I perform and my patients are back functioning fully in just a few days.  You did not post any photographs so I cannot comment on your particular case or if you even have this condition! Also, since you mentioned that its "not a constant problem" you need to be evaluated to make sure you don't have any other medical causes for your condition. You need an in-person consultation with a board-certified, fellowship-trained Oculofacial Plastic Surgeon with extensive experience in ptosis repair and eyelid surgery. Please avoid any doctors that do eyelid surgery part time, they cannot help you. I wish you well with your surgery! 

Damon B. Chandler, MD

Harvard-Penn Trained Oculofacial Plastic Surgeon

Changing eyelid position, particularly when worse at the end of the day or after feeling tired, is concerning for a neuromuscular problem. Although you are young, I would suggest seeing an oculoplastic surgeon for a full evaluation and in-office testing. He or she may recommend obtaining bloodwork or having you see a neurologist based on their assessment. If the eyelid position is lower than average at baseline, and in the absence of other conditions, you would be a candidate for ptosis repair, which can be done in several different ways. 

Droopy eyelids can be repaired simultaneously with blepharoplasty. I do this frequently and can be done at the same time. This is called an “eyelid ptosis repair”.

A droopy (ptotic) eyelid that occurs when tired could be a sign of an underlying condition called myasthenia gravis. Myasthenia gravis is a condition that results in weakening of muscles, especially when tired. Since the eyelid muscles are among the most active in the body, ptosis that occurs when tired can be the first sign of myasthenia gravis.

Once this condition has been ruled out , a variety of outpatient procedures that are safe and highly successful are available to repair a drooping eyelid.

A droopy eyelid can be cosmetically displeasing and may also reduce your field of vision. The 2 most common causes in your age group are either a detached eyelid muscle (following chronic use of contact lenses, trauma or surgery) or a congenital droopy eyelid (which means you were born with it). These causes are not dangerous and require no further investigation. However, I suggest consulting an ophthalmologist to help determine the exact origin of your problem because, in rare cases, a droopy eyelid may be a manifestation of a more serious disease, such as certain neurological or muscular conditions that can lead to other, sometimes life threatening complications. Thankfully, this is rare. Once the cause has been established, the droopy eyelid can be treated with either medication or more commonly, surgery. The final result can often be spectacular. Good luck!