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Two avocados with each having half of one side cut to represent blepharoplasty

Droopy eyelids - what causes them, and how to tell if you need help

You can be born with droopy eyelids, or they can appear at a later stage in life. The latter is more likely as, with age, they become more common, and many people choose to get treatment.

There are several ways to treat droopy eyelids, ranging from surgical interventions to exercises and eye drops. But what’s the right option for you? And what causes droopy eyelids in the first place?

What are droopy eyelids?

Droopy eyelids are often referred to by their scientific name: ptosis. If the condition affects one eye, it’s called unilateral ptosis. If it affects both, it’s bilateral.

In short, ptosis is when the upper eyelid hangs down lower over the eye. This can be due to sagging skin, weakened muscles, or both. There are a few scientific terms for different varieties of ptosis, including aponeurotic (common with age), neurogenic (related to nerves) and myogenic (related to muscles).

Droopy eyelids can cause other eye problems, including:

  • Tiredness and aching.
  • Dryness.
  • Wateriness.
  • Obscured vision.

While generally a benign condition, droopy eyelids can interfere with your eyesight and signify wider health issues. Speak to a clinician if you get sudden droopy eyelids.

What causes droopy eyelids?


Sometimes, ptosis appears from birth and is often the result of genetic factors. The causes of congenital ptosis can include conditions like genetic myonic dystrophy (weakened muscles).


Ageing is the most common cause of droopy eyelids – and the condition most often appears during our 50s and 60s.

As we age, the eye muscles weaken, and the skin becomes looser because our body slows the production of collagen and elastin. For some people, this can cause the eyelid to sag.


There is a connection between tiredness and droopy eyelids – which can be a product of a stressful or unhealthy lifestyle. Our eyelid muscles need sleep to recharge which is why we can often look noticeably tired around the eyes after lack of sleep.

Other factors

There are a few other factors that could lead to ptosis. These include:

  • Wearing hard contact lenses.
  • Excessive and frequent eye rubbing.
  • Eye surgery.
  • Botox injections, which can paralyse the eyelid or brow if injected in the wrong area.
  • Muscular or nerve diseases, including myasthenia gravis or Horner’s syndrome.
  • Wider illnesses, including strokes.

If you’re concerned about sudden droopy eyelids or ptosis that gets worse throughout the day, you should seek advice from your doctor.

How you might treat droopy eyelids

Eye drops

Your clinician might prescribe apraclonidine or Upneeq eye drops to help with the condition.

  • Apralondine drops can reduce pressure in your eyes by decreasing the amount of fluid and causing the eyelid muscles to contract – lifting the lid by a few millimetres. These are a short-term solution, often lasting about one month.
  • Upneeq eye drops can lift the eyes in just 15 minutes. However, they only last about six hours. It works in a similar way to apraclonidine – reducing pressure and causing eyelid muscles to contract.


Botox blocks nerve signals to the eye muscles, causing them to relax and lift the eyelid which can be helpful. Botox injections don’t last forever – you’ll likely need repeat injections every three to six months depending on how long they last for – everyone is different. A single Botox unit can start at around SR42.


Fillers are a minimally invasive gel injection that smooth out wrinkles, lift droopy eyelids and fill in contours. The effects of dermal fillers can last anywhere between three months and two years so you will need regular top ups to maintain the look.


Surgical options can often provide more permanent results. A blepharoplasty is a common skin tightening procedure that removes excess skin and fat from the upper eyelid before repositioning and tightening the skin. This can permanently improve the appearance of droopy eyelids but doesn’t tackle the underlying laxness or muscular issues.


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