Droopy eyelids can make it difficult to keep your eyes open, giving you a sleepy appearance and potentially interfering with vision. There are three main causes of droopy upper eyelids: (1) weakness of the levator muscle that opens the eyelid, known as ptosis, (2) excess upper eyelid skin, known as dermatochalasis, and (3) mechanical brow drooping.
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.
When the eyelids are not well opposed to the globe or are too wide open, this can lead to ocular irritation, tearing, and blurry vision. Due to a variety of causes, including previous eyelid surgery, eyelid laxity or other abnormalities, the eyelids may turn inward (entropion) or outward (ectropion). The eyelids can also become very loose, causing them to not function properly, and require tightening. Additionally, the upper or lower eyelids can become retracted due to different factors such as in the case of thyroid eye disease. A thorough exam and history will help tailor the surgical approach to your eyelid malposition for best results.
Eyelid skin is prone to developing lesions, growths and bumps. Some are benign, some infectious and others may be malignant (i.e. cancer). The first step in evaluating an eyelid lesion is a careful clinical exam. If warranted, a biopsy can be performed. If the lesion is malignant, then a complete excision for clear margin is required for a cure. Oculoplastic surgeons are particularly adept at reconstructing the eyelids and surrounding structures. If you have a concerning lesion, do not hesitate to make an appointment for an evaluation and possible biopsy.