A droopy eyelid can be a serious medical emergency or nothing more than the results of a sleepless night spent tossing and turning. Obviously, you don’t want to confuse the two situations, so know what to recognize to help yourself or help someone else!
There are a few normal droops that can happen in life and the thing to remember is that these droops either form slowly or have been there forever. The more common eyelid droops include:
Dermatochalasis: A bilateral eyelid drooping caused by aging. The elasticity of our connective tissues weakens over time; we get wrinkly and saggy. This change is normal and can be addressed by an oculoplastic surgeon.
Congenital Ptosis: An eyelid droop that has been present since birth and does not change. We must ensure that if a child has a permanent droopy lid, that it is not too low. A low eyelid can prevent that eye from seeing the upper field of view and can result in a weaker eye-brain connection over time.
Trauma: This is not “normal” per se; eye trauma is a not good thing. But if someone has a puffy/droopy eyelid from a traumatic experience, it should resolve as swelling goes down (and that’s a normal progression). However, it should always be evaluated by an eye doctor for other problems associated with eye trauma
What's Not Normal?
First of all - sudden changes! If a sudden change (in lieu of direct trauma) causes a droopy eyelid, it can indicate a host of problems and may even be life-threatening. Here are some conditions that can cause an acute droopy eyelid:
Horner’s Syndrome: This disease is a neurological disorder often caused by something more serious like a stroke, tumor or spinal cord injury. One of the major symptoms is a droopy eye lid (a tiny pupil and no sweat production are the other two) on one side of the face.
Bell’s Palsy: There is one muscle to open the eyelid, and one muscle to close the eyelid; Bell’s Palsy affects the muscle that closes the eyelid. It is a temporary weakness or paralysis to the facial muscles and can permanently damage the nerve that controls the upper eyelid. This leads to other problems like severe dry eye due to constant exposure and lack of blinking.
Ectropion: This is not an emergency but can be caused by various changes in the tissues of the lower eyelid. Most commonly, the lower eyelid will droop away and allow dirt and debris to collect in the lower conjunctival sac. This often leads to infection, inflammation, and general irritation.
So there you have it. Now you know what to look for if you or someone you know has a droopy eye lid - to worry, or not to worry. If it’s still unclear what the cause of the droop is, it is always a good idea to visit an optometrist or ophthalmologist for clarification.