Ptosis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Ptosis?
An ophthalmologist, a medical doctor who treats eye problems and does eye surgery, usually treats ptosis, which means a drooping upper eyelid. Children with a drooping eyelid should see an ophthalmologist. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is ptosis?
Ptosis is another name for eyelid drooping. The edge of the upper eyelid sits lower than it should. Some people also have extra baggy skin in the upper eyelid, which is called dermatochalasis. Eyelid drooping is often a mix of both problems.
Drooping can happen in one or both eyelids. When it is present at birth or starts in the first year of life, it is called congenital ptosis.
Symptoms
The main sign is an upper eyelid that hangs low. The lid may cover only the top of the eye, or it may cover the whole pupil, the dark center of the eye. Other problems can include:
- A sense that the very top of your field of vision is blocked at first.
- Vision that may be fully blocked when the lid covers the pupil.
- Tiredness and achiness around the eyes.
- More tearing, even though the eyes feel dry.
Children may tip their head back to see under the lid. They may also raise their eyebrows to try to lift the eyelid.
Causes and who gets it
A drooping eyelid is most often due to a weak muscle that raises the eyelid, damage to the nerves that control that muscle, or loose skin on the upper eyelids. It can come from normal aging, be present before birth, or follow an injury or disease.
Diseases that may lead to eyelid drooping include:
- A tumor around or behind the eye.
- Diabetes.
- Horner syndrome, a nerve condition that affects the eye.
- Myasthenia gravis, a condition that weakens muscles.
- Stroke.
- Swelling in the eyelid, such as with a stye.
In children, causes also include trauma at birth, such as from forceps, eye movement disorders, and brain and nervous system problems. Most cases of drooping eyelids are due to aging, and no disease is involved.
How doctors diagnose it
When only one side droops, it is easy to see by comparing the two eyelids. It is harder to spot when both sides droop or the problem is slight. Comparing the eyelids with old photos may help show how much they have changed.
A doctor will do a physical exam to find the cause. Tests may include a slit-lamp exam, which is a close look at the eye with a special light, and visual field testing. In children, doctors may also test eye movement. Other tests may check for diseases that could be causing the droop.
Treatment
If a disease is found, it will be treated. Eyelid lift surgery can repair a sagging or drooping upper eyelid. In milder cases, it can improve the look of the eyelids. In more severe cases, surgery may be needed because the lid gets in the way of vision.
In children, surgery may be needed to prevent amblyopia, also called lazy eye. If vision is not affected, surgery can wait until age 3 to 4. In severe cases, surgery is needed right away. A child may also need an eye patch to strengthen the weaker eye, or special glasses for astigmatism, a curve in the eye that blurs vision. Children with mild ptosis should have regular eye exams to make sure lazy eye does not develop. Some children need more than one surgery.
When to see a doctor
Contact your health care provider or an eye doctor if the drooping affects your looks or your vision. A droop in one eyelid can be a sign of a serious disease that needs urgent testing.
See an ophthalmologist for a drooping eyelid in a child, or for drooping that bothers you in an adult. Call 911 or go to the emergency room if one eyelid suddenly droops or closes, or if the droop comes with double vision, pain, a headache, or neck pain. Also call 911 if you have fainting or loss of consciousness, sudden weakness, or you cannot speak.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can check the eyelid, ask about other symptoms, and send you to an eye doctor. They can also help you manage long-term conditions such as diabetes, which can lead to eyelid drooping.
Common questions
Does ptosis only happen in older people?
No. Aging is one cause, but a drooping eyelid can also be present before birth or result from an injury or disease.
Can ptosis hurt a child's vision?
Yes, it can. In children, more severe drooping may lead to lazy eye (amblyopia), which may result in long-term vision loss.
Does ptosis always need surgery?
No, not always. Most cases are due to aging and there is no disease involved, and surgery is done for the look of the eyelid or when it blocks vision.
Does surgery for ptosis work?
In most cases, yes. Surgery is very successful in restoring appearance and function, but the outcome depends on the cause.
Sources
- MedlinePlus - Eyelid drooping
- MedlinePlus - Ptosis - infants and children
- American Academy of Ophthalmology - 5 Causes of Dangerous Asymmetric Ptosis
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
