If your upper eyelids look heavier than they used to, you may wonder what causes droopy eyelids. Drooping eyelids can make your eyes look tired, older, or uneven. In some cases, they can even block part of your upper field of vision.
While people often use the term “droopy eyelids” to describe any sagging around the eyes, there are several possible causes. Finding out what’s causing your droopy eyelids is the first step toward choosing the right treatment.
Common Causes of Droopy Eyelids
People use the term “droopy eyelids” to describe a few different conditions. In some cases, the eyelid itself sits lower than normal, a condition called ptosis. The eyelid may cover part of the pupil, making one eye look smaller than the other.
In other cases, the problem is dermatochalasis. This is loose, excess skin that hangs over the upper eyelid and creates a hooded appearance. Some people have both conditions.
Why Do Eyelids Droop With Age?
Aging is the most common cause of droopy eyelids. Over time, the skin around your eyes becomes thinner and loses elasticity. The tissues that support the eyelids also stretch, which can lead to:
- Loose or folded upper eyelid skin
- Puffiness around the eyes
- Uneven eyelids
- A heavy feeling around the eyes
- Reduced upper field of vision
Your eyebrows may also settle lower with age, making the upper eyelids look even heavier. Some people constantly raise their eyebrows to see more clearly, which can lead to forehead fatigue or headaches.
Can You Be Born With Droopy Eyelids?
Yes. Some people are born with ptosis because the muscle that lifts the eyelid didn’t develop normally. This is called congenital ptosis.
A child with congenital ptosis may:
- Have one eye that appears smaller
- Tilt the head back to see better
- Raise the eyebrows to lift the eyelid
- Have an eyelid that covers part of the pupil
A droopy eyelid can affect normal vision development and may lead to amblyopia (lazy eye). Children with droopy eyelids should be evaluated by a pediatric eye specialist.
Can Swelling Cause Droopy Eyelids?
Anything that makes the eyelid heavier can cause it to droop, including:
- A stye
- A cyst
- An allergic reaction
- Eyelid inflammation
- Scar tissue
- A benign growth
- A tumor in or around the eyelid
Can a Medical Condition Cause Droopy Eyelids?
Sometimes a drooping eyelid develops because a medical condition affects the muscles or nerves that control the eye.
For example, myasthenia gravis can weaken the muscles that lift the eyelid. The drooping often gets worse with activity and improves with rest. Double vision may also occur.
If a drooping eyelid develops suddenly along with any of the following symptoms, seek medical care right away:
- Double vision
- Unequal pupils
- A severe headache
- Difficulty moving the eye
- Facial drooping
- Arm or leg weakness
- Trouble speaking or walking
- Difficulty swallowing or breathing
How Does a Plastic Surgeon Evaluate Droopy Eyelids?
Your plastic surgeon will examine your eyelids, eyebrows, and the surrounding tissues to determine what’s causing the drooping. They’ll also check whether the eyelid blocks part of your vision and review your medical history, previous eye surgery, or injuries.
Older photographs can help show whether the drooping is new or has been present for years.
If your symptoms suggest an eye, muscle, or nerve condition, your surgeon may recommend seeing another specialist before treatment.
How Are Droopy Eyelids Treated?
Treatment depends on what’s causing your droopy eyelids. For some people, eyelid surgery may be an option to improve vision, reduce heaviness, or create a more refreshed appearance.
Upper Blepharoplasty
Upper blepharoplasty removes excess upper eyelid skin and, when needed, adjusts fat to create a more open appearance. It can also improve vision when loose skin hangs over the eyes.
Ptosis Repair
Ptosis repair raises the eyelid by tightening the muscle that lifts it. If you have both ptosis and excess skin, your surgeon may recommend combining ptosis repair with upper blepharoplasty.
Brow Lift
A brow lift may be recommended if low eyebrows are contributing to heavy upper eyelids.
What Causes Droopy Eyelids? Schedule a Consultation
Wondering what causes droopy eyelids? Schedule a consultation with Dr. Stephen Madry in Barrington, IL. He can identify the cause of your drooping eyelids, explain your treatment options, and recommend a personalized plan to restore a more refreshed, natural-looking appearance.