Droopy eyelids can interfere with vision as well as create cosmetic concerns. It is a normal symptom of aging, to some extent. However, according to Virginia E. Bishop, contributor to "Foundations of Low Vision," when eyelids occlude the pupil, surgical correction is indicated. Causes include: nerve disorders such as Horner's syndrome, systemic diseases such as diabetes, injury, tumors or infections and muscular weakness caused by a disorder such as myasthenia gravis.
Muscle Weakness
"Ptosis" is the medical term used to describe the condition of droopy eye. Muscle weakness can cause the eyelid to droop and cover the entire pupil, affecting both or one eye. Dr. Janet G. Derge of the American Medical Network reports that congenital ptosis is caused by a developmental problem involving the levator muscle, which raises the upper eyelid. Ptosis can also be one of the first symptoms of the muscular disorder, myasthenia gravis. According to the Myasthenia Gravis Foundation of America, the most common form of this disease is a chronic autoimmune neuromuscular disorder that causes fluctuating weakness of the voluntary muscles, including the ocular-motor muscles of the eye.
Neurological Disorders
According to Dr. Andrew Weil, Horner's syndrome is caused by injury to the nerve fibers that connect the eye and brain, resulting in a droopy eye and constricted pupil. Symptoms typically occur on one side of the face. Weil describes the path of the fibers as snaking down the spinal cord to the chest and back up to the head and eye. Abnormalities such as a tumor, stroke and injury to the carotid artery can interfere with neurological function, causing a droopy eye. According to the American Association for Pediatric Ophthalmology and Strabismus, congenital Horner's syndrome can be caused by neck trauma during birth and is associated with brachial plexus injury. In addition, congenital or acquired cases may be caused by a tumor growing in another part of the body. Droopy eyes are also a symptom associated with Marcus Gunn Jaw wink. According to Eyeplastics.com, this disorder involves abnormal muscle innervations so that the eyelids open during mouth movement.
Systemic Diseases
According to the Department of Ophthalmology and Visual Sciences at the University of Illinois, several systemic diseases cause droopy eye and other eye symptoms. These diseases include: diabetes, AIDS, the thyroid disorder Grave's disease, lupus, rheumatoid arthritis, hypertension, sickle cell disease and multiple sclerosis. Diabetes can cause severe vision loss due to changes in the retina's blood vessels. Infections and abnormal circulation in the retina caused by AIDS can result in severe vision loss or blindness. Eye problems are often an early sign of a disease such as Graves where the eyes protrude, eye movement is limited and the patient may experience double vision and corneal disease. Sickle cell disease impedes circulation and may cause bleeding inside the retina, and multiple sclerosis damages nerve coverings causing eye movement problems and vision loss.
The Impact of Aging
Aging causes all muscles to weaken and droop and eye muscles are no exception. According to Healthhype.com, aging causes the levator muscles to stretch, creating wrinkles and sagging around the eyes. Cosmetic surgery can lift the upper eyes, improving appearance. In addition, individuals who suffer central vision loss from age-related macular degeneration may opt for surgery to prevent further vision loss due to drooping eyelids that cover part of the eyes. Peggy R. Wolfe, author of "Macular Disease: Practical Strategies for Living with Vision Loss," reports that drooping eyebrows can cause the eyelids to droop and that Medicare should cover approved surgical procedures to correct this since drooping can limit the visual field.
References
- University of Illinois at Chicago: The Eye in Systemic Disease
- "Macular disease: Practical Strategies for Living with Vision Loss"; Peggy R. Wolfe; 2008
- American Association for Pediatric Opthalmology and Strabismus: Anisocoria and Horner's Syndrome
- American Medical Network: Drooping Eyelids
- Causes of Droopy Eyes and Ptosis
