Droopy eyelids can make it difficult to keep your eyes open, giving you a sleepy appearance and potentially interfering with vision. For good vision, the margin of the upper eyelid – the location of the lashes – should easily clear the pupil (dark circle in the middle of the iris). Peripheral vision is most affected by droopy eyelids, making it harder, even dangerous, to drive. When working on a computer, droopy heavy eyelids can make staring at the screen very challenging. And when reading, droopy eyelids may drop further to cover part of the pupil, making reading difficult.
There are three causes of droopy eyelids: (1) weakness of the muscle that opens the eyelid (levator palpebrae superioris), (2) excess eyelid skin, and (3) mechanical brow drooping. When the drooping is caused by weakness of the levator muscle, it is referred to as “true ptosis” (the first ‘p’ of ‘ptosis’ is silent). When the brows are very droopy causing mechanical brow ptosis, they press on the upper eyelid skin and cause it to bunch up, giving the appearance of even more excess eyelid skin (dermatochalasis).
A customized approach to droopy upper eyelids requires a complete eye exam, including assessment of eyelid muscle function as well as skin height and brow position. The goals of treatment depend on whether your primary concern is functional (i.e. vision is affected) or cosmetic. Of course, ALL eyelid surgery must be performed aesthetically, and Dr. Kahana is an expert in optimizing the appearance as well as the function of upper eyelids, with a focus on brow-eyelid crowding, eyelid crease, eyelid platform, and lash position.