Repairing droopy eyelids

Beyond merely looking tired, droopy eyelids can lead to problems with daily functions like walking and driving


Muscles and tendons lose their tone later in life, and the eyelids are no exception. Unfortunately, you can’t simply lift weights to keep the levator muscle, which is responsible for lifting the upper eyelid, in shape. With age (or excess rubbing like that associated with itchy eyes), the levator muscle and its connective tendon can stretch out and cause the eyelid to fall, a condition known as ptosis. Older adults also commonly experience dermatochalasis, when excess skin loses elasticity and weighs down the upper lid. Both issues result in droopy eyelids that make a person look half asleep.

While saggy eyelids may seem like just a cosmetic complaint, the functional impact of this common condition is rather eye-opening. “Droopy lids and excess skin above the eyes can impede a person’s superior and lateral fields of vision—in other words, they have trouble seeing things above and to the side,” explains Dr. Sudeep Das, a Roper St. Francis Healthcare affiliated ophthalmologist. “If the condition only affects one eye, there also may be depth perception issues.” This visual impairment can impede driving, reading, walking and even stair climbing.

The face will naturally compensate for this reduced visual field, trying to raise the eyelid by lifting the forehead. “My patients often tell me that they have to act surprised in order to see,” says Dr. Das. Overusing the forehead muscles in this way can lead to a headache or brow ache at the end of each day.

If droopy eyelids are impacting your daily life, consistently bothersome or slowly worsening, speak to your eye doctor. While not much can be done to prevent age-related drooping of the eyelid, doctors can perform a variety of outpatient surgeries to correct the problem.

Surgical Solutions

To lift droopy eyelids, doctors use three common outpatient procedures frequently covered by insurance.

Blepharoplasty: Colloquially called an eyelid lift, this surgical procedure treats dermatochalasis by removing excess skin in the upper eyelid and brow through an incision in the upper eyelid crease.

External levator advancement: This ptosis surgery tightens the levator aponeurosis tendon in the eyelid. It can be performed at the same time as a blepharoplasty, since the procedure also goes through an incision in the lid crease.

Müller muscle-conjunctiva resection: This slightly less invasive ptosis repair involves a little incision on the inside of the eyelid to shorten a small muscle on the backside of the lid. While the recovery can be faster and scarring can be less, not every patient is a good candidate.

New Research: Too Strict?

Research points to an overdiagnosis of chronic kidney disease

Healthcare is constantly refined as doctors learn more about the human body’s precise operation. A recent study published in JAMA Internal Medicine calls for revised guidelines surrounding chronic kidney disease, worrying that current measures unnecessarily diagnose many seniors with the condition. Kidney performance is measured by how much blood passes through the organ’s tiny filtration vessels each minute, called glomerular filtration rate (GFR). A GFR of less than 60 is currently a red flag for chronic kidney disease. But the study of more than 127,000 men and women found that the risk of kidney failure in seniors with a GFR below 60 was essentially the same as those with a healthy GFR. In other words, a low GFR in older adults may simply reflect the normal, age-related decline of kidney function rather than organ failure.