Ptosis (Droopy Eyelid): When to Consider Surgery
- The Straits Eye Centre
- Sep 19
- 4 min read
Introduction: More Than Just a Cosmetic Concern
Ptosis, commonly called droopy eyelid, is not just about looks. When the upper eyelid falls lower than normal, it can interfere with vision, cause eye strain, and affect confidence. Ptosis can affect one or both eyes, and its severity ranges from mild drooping to complete eyelid closure.
In Singapore, ptosis is a common reason people seek eye specialist care. While mild cases may only cause cosmetic concerns, moderate to severe ptosis often requires medical attention, including surgery, to restore both vision and comfort.
What Is Ptosis?
Ptosis occurs when the muscle responsible for lifting the eyelid (the levator muscle) weakens, stretches, or detaches. This can happen for several reasons:
Congenital ptosis: Present at birth due to poor muscle development.
Acquired ptosis: Develops later in life, often from aging, trauma, or medical conditions.
Causes of Ptosis
Age-related changes: The most common cause, where the eyelid muscle stretches over time.
Congenital factors: Weak eyelid muscle from birth.
Neurological conditions: Nerve damage or disorders affecting eyelid control.
Trauma or surgery: Eyelid injury or after cataract/eye surgery.
Systemic conditions: Such as myasthenia gravis.
Symptoms of Ptosis
Drooping eyelid(s), one or both sides.
Needing to tilt the head back or raise eyebrows to see clearly.
Eye strain, especially when reading.
Reduced field of vision.
Uneven appearance of eyes.
When Does Ptosis Need Treatment?
Mild drooping may not require intervention. However, you should seek medical advice if:
The eyelid blocks part of your pupil and affects daily vision.
You develop neck or forehead strain from trying to lift your eyelid.
Children with congenital ptosis risk amblyopia (lazy eye).
Drooping worsens suddenly, which may signal neurological problems.
Diagnosis of Ptosis
An eye specialist will perform:
Eyelid measurements (margin reflex distance, levator function).
Eye examination to rule out other causes of drooping.
Visual field test if vision is blocked.
Neurological assessment in select cases.
Treatment Options for Ptosis
Non-Surgical Options
Observation for mild cases with no functional impact.
Ptosis crutches (spectacle attachments that lift eyelids). Rarely used.
Surgical Options
Levator resection or advancement: Tightens the eyelid muscle for better lift.
Frontalis sling surgery: Connects the eyelid to the forehead muscle, used in severe or congenital ptosis.
Surgery is customised depending on severity, cause, and patient age.
Benefits of Ptosis Surgery
Improved visual field.
Reduced eye strain and headaches.
Balanced, natural eyelid appearance.
Better quality of life and confidence.
Risks of Surgery
Like all surgeries, ptosis correction carries some risks:
Asymmetry between eyelids.
Under- or over-correction.
Dry eyes or incomplete eyelid closure.
Infection or bleeding (rare).
Most patients recover well with good outcomes when surgery is performed by a qualified eye specialist.
Recovery After Ptosis Surgery
Outpatient procedure, usually under local anaesthesia.
Mild swelling and bruising for 1–2 weeks.
Ice packs and prescribed ointment aid healing.
Return to normal activities within 1–2 weeks.
Full results visible after swelling subsides.
Frequently Asked Questions
1. Is ptosis surgery cosmetic or medical?
It can be both. If the eyelid obstructs vision, it is considered medical and may be insurance claimable.
2. Can children outgrow congenital ptosis?
No. Without treatment, ptosis may lead to lazy eye. Surgery is often recommended.
3. Does ptosis always need surgery?
No. Mild ptosis without symptoms may be observed. Surgery is needed if vision is affected or for cosmetic concerns.
4. How do I know if my ptosis is serious?
If your eyelid blocks your pupil, causes neck strain, or develops suddenly, seek medical care promptly.
5. Is ptosis surgery painful?
It is usually well tolerated under local anaesthesia. Mild discomfort is expected during recovery.
6. Can ptosis recur after surgery?
Yes, especially in age-related cases. Revision surgery may be needed in some patients.
7. How long do results last?
Most surgical results are long-lasting, though natural aging may cause changes over time.
8. Can insurance cover ptosis surgery in Singapore?
Yes, if it is medically necessary and vision is affected. Cosmetic-only cases are usually not covered.
Meet Our Specialist
At The Straits Eye Centre, your vision care is in the hands of a dedicated team of experienced ophthalmologists. Each of our doctors brings unique expertise and a shared commitment to delivering thorough, patient-focused care for all ages. Whether you need advanced cataract surgery, paediatric eye management, or treatment for complex eye conditions, our team works together to provide the same attentive care we would want for our own families.
Dr Jason Lee
Senior Consultant & Medical Director
Special interest: Oculoplastics, General Ophthalmology, Myopia, Cataract, Diabetic Retinopathy Dr Jason Lee has extensive training in eyelid, orbital, and tear system surgery, with fellowships completed in Taiwan and China. Previously a Senior Consultant at Khoo Teck Puat Hospital, he co-founded The Vision Mission, a non-profit bringing sustainable eye care to communities in Asia.
Cost, Medisave, and Insurance
Many procedures at The Straits Eye Centre are eligible for Medisave claims under MOH guidelines, and certain insurance plans may cover part or all of your treatment costs. Our patient care team will guide you through eligibility, claim limits, and paperwork, so you can focus on your recovery. For more details, refer to our Medisave & Insurance Guide.
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