What Causes an Eyelid to Droop?

If you’re getting older, looking in the mirror might cause you to ask, “What causes an eyelid to droop?” Read on to explore the many, many reasons this can occur, as described by the experts at Elmquist Eye Group.

Elmquist Eye Group has been serving Southwest Florida for 25 years. E. Trevor Elmquist, DO, his partner, Kate Wagner, OD, his associate, Nina Burt, OD,  and ophthalmologist Sarah Eccles-Brown, MD, offer wide-ranging expertise in eyelid surgery and the most up-to-date eyecare treatments.

What Causes an Eyelid to Droop?Unfortunately, one of the first signs of aging occurs in the upper and lower eyelids where the skin is thinner. Sagging begins, and the upper eyelid skin and muscles might even begin to block our vision. As we constantly try to keep our eyes open, the forehead skin might get more visible wrinkles, too.

As we age, our skin loses elasticity. The thin skin around the eyelids is particularly susceptible. The excess skin begins to bulge, wrinkle and sag, particularly on the lower lid. Sagging skin on the upper lid might cover the eyelashes or even interfere with vision.

There are other contributing factors that cause our eyelid tissues to change, including wear and tear from rubbing the eyes, sun damage, and smoking. If one or both of the eyelids droop, or we find that we have to tilt our head back and lift the chin to see better, the droop is affecting eyesight. We may also constantly feel the need to arch the eyebrows to lift the eyelids.

While most eyelid droop comes from age, some people might also develop it for other reasons. Nerve damage around the eyelid muscles can lead to lid droop. Genetics play a role as well. Eyelid droop can occur from eye injury such as stretching or tearing of the tendon-like covering (called the levator aponeurosis) that causes eyelid movement. Many patients who excessively rub their eyes or who use rigid contact lenses have this issue. Damage from previous eye surgeries can cause the lid droop as can damage from repeated Botox injections.

In some rare diseases, eyelid droop is a consequence, as it is in myasthenia gravis, a weakening of the voluntary muscles, and Horner’s syndrome, a rare disorder that involves damage to the muscles that control the eyelid. Some patients develop eyelid tumors or swelling as well.

Eyelid droop can be treated. Doctors usually won’t recommend surgery unless the vision is affected. Many patients, however, simply do not like their appearance, and opt for a cosmetic procedure called a blepharoplasty. In this treatment, the doctor removes the excess sagging skin and also tightens the muscle that lifts the eyelid.

Our surgeons can operate on all four lids at once in a procedure that takes about two hours. We usually start with the upper lids. First, we provide IV sedation for your comfort. We cut along the natural lines of your eyelids for a natural appearance. We remove the excess fat and skin and close with very small stitches that will remain in for about a week.

Your eyelids are important, so pay attention to them. After all, the eyelids’ primary function is to protect your eyes from injury, control the amount of light, and help distribute tears across the entire eye.

If you are asking yourself what causes an eyelid to droop, please give Elmquist Eye Group a call at (239) 936-2020 for a blepharoplasty evaluation, and find out if you would be a good candidate for the procedure.