Droopy Eyelids (Ptosis) — Newcastle Eyelid Specialist
Droopy eyelids, known medically as ptosis, are one of the most common conditions I see in my eyelid clinic in Newcastle. Many patients come to me having noticed a gradual drooping of one or both upper eyelids over a number of years, often putting it down simply to tiredness or ageing before realising it may be affecting their vision or everyday comfort.
In some cases, the eyelid begins to cover the pupil, making it harder to see clearly — particularly when reading, watching television, or driving. If this sounds familiar, you are not alone, and in most cases the condition can be treated effectively.
What is ptosis?
Ptosis is the medical term for a drooping of the upper eyelid. It can affect one eye or both, and ranges from a barely noticeable droop to a significant lowering of the eyelid that visibly obscures the pupil.
The eyelid is lifted by a muscle called the levator palpebrae superioris. In the majority of patients I see, ptosis develops when this muscle gradually weakens or stretches over time — a process that is a normal part of ageing.
What causes a droopy eyelid?
The most common cause by far is age-related weakening of the levator muscle, a condition known as aponeurotic ptosis. The tendon connecting the muscle to the eyelid slowly stretches, causing the lid to descend.
Other causes include:
Previous eye surgery or prolonged contact lens wear, which can stretch the levator muscle over time
Neurological conditions, such as a third nerve palsy or Horner's syndrome — these are less common but important to identify
Myasthenia gravis, a condition affecting the neuromuscular junction which can cause variable drooping that fluctuates throughout the day
In the vast majority of patients, the cause is straightforward and can be confirmed during a clinic assessment. Where there is any uncertainty, I will arrange appropriate investigations before recommending treatment.
What are the symptoms of ptosis?
Drooping of one or both upper eyelids
A reduced field of vision, particularly in the upper part
Difficulty reading, watching television, or driving
Needing to raise the eyebrows or tilt the head back to see more clearly
A tired or heavy feeling around the eyes
Headaches from the effort of keeping the eyelids open
Many patients tell me they had not realised how much their eyelids were affecting their day-to-day life until after treatment.
When should you see a specialist?
It is worth arranging an assessment if your eyelid drooping is:
Affecting your vision or field of sight
Getting progressively worse over weeks or months
Associated with double vision, pain, or a change in the size of your pupil — in which case you should seek urgent advice
Present from childhood or affecting a child (this requires prompt assessment to protect vision development)
Causing you concern, even if mild
Most cases of ptosis are benign and age-related, but a clinical assessment is important to confirm the diagnosis, rule out any underlying cause, and discuss the most appropriate management.
What happens at a consultation?
During your appointment, I will take a full history of your symptoms and examine both eyelids carefully. I measure the height of each eyelid and assess the strength of the levator muscle, as this directly influences which surgical technique is most appropriate.
I will also check that the surface of the eye is healthy and that there are no other contributing factors. I find that most patients appreciate having time to discuss their symptoms and ask questions before making any decision about treatment.
If surgery is recommended, I will explain the procedure in detail, including what to expect on the day, the recovery period, and the realistic outcomes.
How is ptosis treated?
The main treatment for ptosis is surgery to lift the eyelid to a more natural and functional position. This is one of the most commonly performed eyelid procedures, and most patients are very pleased with the result.
The procedure:
Is performed under local anaesthetic as a day case — you will be awake throughout but the eyelid area is numbed so you should not feel pain
Usually takes around 30 to 40 minutes per eyelid
Is performed through a small incision hidden in the natural eyelid crease
Uses fine absorbable stitches that do not need to be removed
The exact surgical technique depends on the degree of drooping and how well the levator muscle is functioning. In most age-related cases, I tighten the levator muscle or its tendon to lift the lid to the correct height.
Is ptosis surgery painful?
The procedure itself is not painful. Local anaesthetic is injected into the eyelid at the start, which causes a brief stinging sensation, and the area is then numb for the duration of the procedure. Some patients feel mild pressure or movement during surgery, but pain is not expected.
Afterwards, as the anaesthetic wears off, some discomfort and a feeling of tightness around the eyelid is normal. This is usually well managed with over-the-counter pain relief such as paracetamol.
What is the recovery like after ptosis surgery?
Most patients experience some swelling and bruising around the eyelid in the days following surgery, which gradually settles over one to two weeks. The eyelid may feel slightly tight or look asymmetrical initially, this is a normal part of the healing process.
Most people are able to return to light activities and desk-based work within a few days. I advise avoiding strenuous exercise and swimming for around two weeks.
A follow-up appointment is arranged to check on healing and ensure you are happy with the result.
What results can I expect?
The aim of surgery is to lift the eyelid to a natural, symmetrical position that improves both vision and comfort. Most patients notice an immediate improvement in their field of vision and the tired appearance of their eyes.
As with any surgical procedure, perfect symmetry cannot be guaranteed, small differences between the two sides are common and usually settle with healing. Occasionally a minor adjustment procedure is needed, and this would be discussed with you at the time.
Ptosis surgery at Newmedica Eye Clinic, Newcastle
All procedures are performed at the Newmedica Eye Clinic in Newcastle upon Tyne, a modern, purpose-built outpatient surgical facility. Treatment is available on a private, self-pay basis.
If you would like to arrange a consultation to discuss your eyelid concerns, please get in touch. I would be happy to see you, assess your eyelids, and talk through the options available.