When is surgery needed for droopy eyelids (ptosis)?

Have you ever experienced droopy eyelids? Droopy eyelids, also known as ptosis or blepharoptosis, can affect both physical appearance and vision. While mild cases may not need treatment, ptosis surgery is an option if ptosis interferes with your daily life. Ptosis surgery will be performed by an ophthalmologist. The benefits after this surgery are many, for example: improved vision, better eyelid position, enhanced appearance, reduced eye strain, among others. Doctify connects patients with trusted ophthalmologists for tailored advice.

What Is Ptosis?

Ptosis, or drooping of the upper eyelid, is a condition that occurs when the upper eyelid droops lower than normal, it can affect one or both eyes. Ptosis can cover the whole pupil and block vision. This condition usually happens since the levator muscle, the muscle that lifts the eyelid, is not working properly. The common causes include: aging, muscle weakness, nerve issues, or present from birth (congenital ptosis).

Signs That Ptosis May Need Attention

• The eyelid blocks part of the visual field.
• Frequent eye strain or needing to tilt the head back to see clearly.
• Significant asymmetry between eyelids affecting appearance and confidence.
• Excessive rubbing of your eyes or increased tearing.
• Decreased or impaired vision.
• Tiredness and achiness around your eyes.
• In children, there is a risk of lazy eye (amblyopia) if vision is blocked.

How Ptosis Is Diagnosed

Ptosis is diagnosed by a specialist called an ophthalmologist. The ophthalmologist in order to diagnose, will first perform an eye examination, afterwards will make tests for eyelid muscle strength and function, and finally will do a visual field testing to assess impact on sight. A complete and detailed medical history is needed to identify systemic conditions or other factors that could influence the surgical outcome.

When Surgery Is Recommended

Surgery for ptosis is recommended in three instances:

• For functional reasons: when vision is obstructed, leading to difficulty reading, driving, or daily activities.
• For cosmetic reasons: when drooping causes distress or visible asymmetry.
• For children: to prevent long-term visual development issues.

Types of Ptosis Surgery

There are various types of ptosis surgery. The procedure choice depends on severity, age, and muscle strength. The types are:

• Levator Muscle Tightening: most common approach to lift the eyelid.
• Müller’s Muscle Advancement: suitable for mild ptosis.
• Frontalis Sling Procedure: using forehead muscle for severe or congenital ptosis.

Benefits and Risks

The benefits after the surgery are multiple, including for example: improved vision, better eyelid position, enhanced appearance, reduced eye strain, among many others. Every surgery has risks, in this case the risks for ptosis surgery are: bruising, swelling, bleeding from the wound, over- or under-correction, or returning to ptosis. Complications that can occur are surgical site infection or damage to the cornea, which are rare. Nevertheless, complications are uncommon when surgery is performed by experienced ophthalmologists.

Contraindications for Ptosis Surgery

It is important to know which are possible contraindications for ptosis surgery, they include:

• Any conditions that place the cornea at risk, such as severe dry eye and poor Bell’s phenomenon. 
• Any condition with inherent neuromuscular dysfunction, like certain myogenic ptosis or myasthenia gravis. 
• Any systemic condition that affects the eye’s health, for example thyroid eye disease, the use of blood-thinning medications, or uncontrolled diabetes and hypertension. 

Recovery and Aftercare

A good aftercare is fundamental, in order to have an optimum recovery. Often with a good aftercare, the patient returns to their daily activities very fast. The ptosis surgery is an outpatient procedure in most cases. The swelling and bruising is normal after the surgery, it usually settles in 1–2 weeks. The patient will return to normal activities within days, but full healing may take several weeks. Follow-up appointments are important as well, to ensure eyelid position is correct.

Questions to Ask Your Doctor

Below are some questions you could consider asking to your ophthalmologist during the consultation.

• Do I need ptosis surgery?
• Which surgical approach is best for me?
• Will I feel relieved of my symptoms after the surgery?
• How severe is my ptosis?
• Can ptosis return at some point?
• Do I need to have a special aftercare?

Conclusion

Ptosis can affect both vision and self-confidence, but surgery provides safe and effective correction. Treatment decisions are individual, based on symptoms and goals. The ptosis surgery is procedure with many benefits and few risks. Often with a good aftercare, the patient returns to their daily activities very fast. If feeling doubtful, we invite you to consult an ophthalmologist via Doctify for a professional assessment and to explore whether surgery is right for you.

Feel free to consult an ophthalmologist through Doctify for personalised advice whenever you want, we will be happy to help you! Find the best ophthalmologists in the United Kingdom or search for the best specialists globally:

• Ophthalmologists in the United Arab Emirates
• Ophthalmologist in Germany
• Ophthalmologist in Austria
• Ophthalmologist in Ireland
• Ophthalmologist in Australia

Medically Reviewed
Last reviewed on 01/10/2025