Can My Eyelids Interfere With My Vision?

By Steven J. Yoon, MD

The eyes are arguably the most beautiful and important organs of our bodies. Vision is an extremely complex sense, requiring the many parts of the eye to work together, and then send these signals to the brain. Each part of the eye may be vulnerable to various eye conditions that affect our vision, such as astigmatism, nearsightedness, cataracts, glaucoma and macular degeneration. But can the eyelids interfere with our vision too?

The eyelids serve to protect our eyes from the dirt and dust in the air, and also function to keep the eyes moist by blinking. When the eyelids begin to droop they may interfere with our peripheral vision. Symptoms include, difficulty keeping the eyes open, eyestrain or brow aches from the increased effort to see, and the need to lift the chin up or even use a finger to push the eyelid out of the way.

There are several conditions that can cause droopy upper eyelids. Ptosis is the medical term to describe when the upper eyelid margin falls to a lower position. As one ages, the attachment from the muscles of the eyelid to the underlying structures get stretched. This type of ptosis is by far the most common type seen in adults, causing the eyelid to cover the pupil and interfere with vision. Children also may develop ptosis due to the abnormal development of the eyelid muscle. A careful exam is recommended because ptosis may sometimes be caused by neurologic or neuromuscular disorders as well.

Droopy eyelids may also be related to the excess skin of the upper eyelid. The medical term for this is dermatochalasis. When a significant amount of excess skin weighs down on the eyelid, it can interfere with the peripheral vision, both above and to the sides. The excess eyelid skin can also give us a tired and sad appearance.

The position of the eyebrows is also very important when looking at droopy eyelids. The position of the brow in men is typically at the bony rim above the eye, and in women it is positioned above the bony rim. When the brow droops, this can cause an increased amount of excess eyelid skin hooding over the eyelids, which also may interfere with vision. Ptosis, dermatochalasis and brow ptosis may coexist or occur independently.

Droopiness of the eyelid can be corrected. Ptosis repair is designed to tighten the eyelid muscle by reattaching the stretched tendon to its normal position. This can be performed through a well-camouflaged eyelid crease incision or a hidden incision on the underside of the eyelid. Dermatochalasis is corrected by the removal of excess skin by what is known as an upper blepharoplasty, or eyelid lift. The droopiness of the brow can also be corrected via various methods.

Droopy eyelids can interfere with our vision and cause bothersome symptoms. Ptosis, dermatochalasis and brow ptosis can be corrected, to regain a full field of vision. Celebrate healthy vision during National Eye Care Month, and make sure the windows to the soul are checked by an eye care professional this year.