Droopy Eyelid (Pediatric Ptosis)

It’s common to see a child’s eyelids droop when they’re tired. However, if you notice your child’s eyelid drooping when they aren’t tired or if your child can’t open their eye all the way, it may be a condition called ptosis.

Ptosis, or a droopy eyelid, can affect one or both eyes and happen to people of all ages. Most ptosis is congenital, and the muscle is replaced by fatty tissue. In more rare instances, it is a nerve issue. Nerves in eyelids get signals from the brain to keep the eyelid muscles lifted in a normal position.

Whether it’s congenital or due to nerve issues, there are several possible causes for ptosis.

• The nerve isn’t transmitting signals from the brain properly due to neurologic disorders or nerve damage.
• The eyelid muscles are weak, not attached or missing.
• There is loose skin in the upper eyelid.
• The eyelid muscle is diseased.

Signs and Symptoms of Pediatric Ptosis

Aside from a drooping eyelid, you may also notice your child:

• Tilting their head back or other movements to see better.
• Telling you they have trouble seeing.
• Bumping their forehead on low-hanging objects.
• Crawling or walking later than expected.

Other eye-related problems can occur with pediatric ptosis, including:

• Misaligned eyes
• Lazy eye, with one eye’s vision becoming weaker than the other
• Astigmatisms, nearsightedness or farsightedness
• Blurred, double or other types of poor vision
• Complaints of eye strain, headaches or dizziness

Treatment for Pediatric Ptosis

There are a variety of treatments for ptosis in children. Treatment depends on how severe the condition is and your child’s age, symptoms and any other medical problems they may be having.

Most ptosis is treated conservatively with patching and/or glasses. Surgery is rarely needed unless the ptosis is severe. When surgery is required, the surgeon tightens the eyelid muscles. If lazy eye has developed, your doctor may prescribe drops or putting a patch over the stronger eye so the weaker eye must work harder.