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What Are the Causes of Droopy Eyes and How to Treat Them?

Ptosis, or droopy eyelid, is a condition where the upper eyelid sags and almost covers the pupil. Children may be diagnosed with this disorder from birth, while adults may develop this as a result of natural aging, lifestyle habits, or due to pre-existing medical illnesses. 

So what are the possible treatment options for droopy eyes? Patients who have drooping eyelids can find relief from blepharoplasty surgeries, ptosis crutches, or apraclonidine eye drops- and also from Botox. When properly placed, Botox “brow lifts” can elevate the eyebrows to help fix droopy eyes. 

What is Ptosis and how do people get it? 

The appearance of sagging skin around the upper eyelid is a common indicator of ptosis or blepharoptosis. Medically, it is described as a condition where one (unilateral) or both (bilateral) of the upper lids droop downward over the eye. It is usually induced by a strain in the frontalis muscle.

The frontalis muscles are located on the upper part of the face and extends upward and laterally across the forehead. When a person makes an expression like laughing or squinting, the muscles contract and it elevates the eyebrows. Repeated movements of the frontalis muscle over time may result in the presence of horizontal lines across the forehead or develop excess skin which causes heaviness in the eyelids and leads to drooping.

Congenital and Acquired Eyelid Ptosis 

Ptosis can happen to both children and adults. In cases of early age drooping, this illness is called congenital ptosis. It is the abnormal positioning of the upper eyelid that is present since birth or may show within the first year of life. It can also be linked to eye-related issues such as eye movement, eye muscle disease, and possible tumor. 

A child with congenital ptosis will have trouble seeing and puts them at risk for developing more serious vision impairments. Amblyopia, or lazy eye, can be a result of droopy eyelid in young kids. It’s a developmental problem where one eye has better vision than the other due to the nerve cells not maturing properly. Other possible side effects are astigmatism (curvature of the eyes which lead to blurred vision) and strabismus (misaligned or crossed eyes). 

Likewise, adults can also get ptosis when the eyelid muscle (called levator muscle) stretches or tears accidentally. This condition is called involutional or acquired ptosis. This can be caused by aging where the eyelid skin loses elasticity and sags, or a result of eye injury from excessive rubbing, use of rigid contact lenses, or a trauma from eye surgery. 

Certain medical conditions such as diabetes can also cause droopy eyes since blood vessels, particularly in the oculomotor nerves, become damaged. When blood flow is constricted, a person will have limited movements in the muscles and cause eyelid drooping. High levels of hormones that cause thyroid diseases may also cause neuromuscular disorders to prevent normal eye function and lead to ptosis. 

Ptosis after Botox 

Individuals who want to get rid of their Crow’s feet, forehead wrinkles and frown lines often opt for Botox cosmetic surgery. It is a minimally invasive procedure that minimizes the obvious effects of aging and restores a youthful glow. It’s usually performed by injecting a neurotoxin called botulinum toxin. 

A Botox injection works by weakening or paralyzing the muscles to stop them from contracting. Repeated facial expressions often stimulate tension in the muscles and cause appearance of wrinkles. When movement in the facial muscles is limited, deep creases and fine lines will appear less prominent and gradually smoothen out as the Botox kicks in the system. 

Among the common injection sites for Botox are between the eyebrows, in the forehead, and around and under the eyes. The said treatment is typically a safe and noninvasive procedure since injections are administered directly on the targeted area. When performed by a trained and licensed plastic surgeon, favorable results are guaranteed and it comes with minimal side effects that lasts for only a few days. 

Botox patients are usually advised to take precautions and avoid touching or disturbing the injection site to prevent the toxin from spreading to other parts of the body. When Botox in the forehead disperses, it can affect brow muscles and cause sagging brow or eyebrow droop. Likewise, when the injection is administered between the eyebrows, the levator muscles will become deadened and cause droopy eyelids. 

While it is a rare side effect of the treatment, around 5% of individuals who get Botox may experience drooping eyelid. Some of the symptoms of droopy eyes after bad botox include eye muscle weakness and heaviness, lazy eye or difficulty opening the eyelid, and vision problems in the peripheral and central sight.

Treatment options for droopy eyes 

Normally, doctors would perform a medical exam to review the patient’s history and current health condition when diagnosing eyelid droop. A person may be required to take a slit lamp exam to see if there is any discomfort when the eye is subjected under high-intensity light. Another option is to do a Tensilon test which uses the drug Tensilon (edrophonium) to determine whether a muscle condition like myasthenia gravis is the cause of eyelid droop.  

Depending on the results of the observation, the doctor can recommend eyelid surgery (known as blepharoplasty) to treat either congenital or acquired ptosis. During the surgery, the levator muscles are repaired which can help raise droopy eyelid. A sling procedure may also be done to elevate the frontalis muscles and lift the brows and eyelid. 

Meanwhile, a nonsurgical alternative is the ptosis crutch where an attachment may be added to the frames of a patient’s eyeglasses. The crutch will help prevent the eyelid droop by supporting the skin in place. Individuals have a choice whether to use adjustable crutches which are put to one side of the frames, or reinforced crutches which are placed to both sides of the frames. Prescription eye drops also help relieve symptoms of ptosis. 

What to do if you get ptosis from Botox 

Droopy eyes from Botox usually get better within 4 to 6 weeks, or when the toxin wears off. But while waiting for the aftereffects to subside, there are immediate treatments that can alleviate the problem such as: 

1. Exercise the muscles 

Stimulating the affected muscles can help reduce the appearance of ptosis. It also speeds up the amount of time the toxin needs to dissolve, allowing the eyelid to naturally elevate. This can be done through applying pressure on the forehead to push them up or repeatedly creating circles through gentle rubs with thumb and index fingers. 

Some doctors also recommend applying electrical stimulation using the back of an electric toothbrush over the affected area. This wakes up the muscles that were relaxed from the Botox injection.

 2. Apraclonidine eye drops

Iopidine or apraclonidine eye drops are prescription treatments that are used to relieve serious high pressure inside the eye, preventing possible loss of vision. Doctors usually suggest one to two drops at least three times a day to remedy the symptoms of Botox-induced ptosis. It works by sending signals to the receptors, awakening certain eye muscles so the lid will elevate at least 1 to 2 mm. 

3. Return for Botox 

Additional Botox injections may also be recommended to counteract the effect of the initial treatment. This helps stimulate different facial muscles to fix the droopy eyes. New units of Botox can be injected into the forehead to lessen the heaviness of the brow and another set of injections under the eyes can open them a little wider. A Botox brow lift may also raise sagging eyebrows and alleviate the appearance of droopy eyes. 

Learn more: How many units of Botox do you need for eyes?

Get safe Botox treatments from experts at Evolve Med Spa

Droopy eyes is a condition which can be observed from birth or induced by a variety of factors such as medical illnesses, muscular damage, and even as a side effect from certain surgical and cosmetic procedures. Ptosis from bad Botox is a temporary condition and will often go away within weeks after the treatment. Prescription eye drops and medication can also mitigate symptoms of droopy eyes. 

If you’re considering Botox treatment for droopy eye problems, let our experts at Evolve Med Spa help you get started on your journey. With our advanced technologies and trained staff, we guarantee safe cosmetic surgeries that will assist you in meeting your aesthetic goals. We provide customized treatment plans according to your needs so we can bring out your natural beauty. Book an appointment now and learn more about how we can make Botox work for you. 

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