People diagnosed with multiple sclerosis (MS) can experience many different vision problems. One such eye problem associated with MS is a droopy eyelid, or ptosis. Ptosis, however, appears less commonly than other eye issues (like optic neuritis). And it’s even more rare for ptosis to be your first symptom of MS.

Still, noticing a droop in one or both of your eyelids sets off alarms. Read on to learn more about the symptoms, causes, and management of ptosis — and when it’s time to talk to your doctor about treatment for droopy eyelids.

What Is Ptosis?

Doctors consider an eyelid “droopy” when the eyelid sags below its normal level. The causes behind a drooping eyelid include a number of factors, like muscle weakness and nerve damage.

Typically, a person with ptosis cannot open their eyelid past a certain point. Ptosis generally affects the upper eyelids. Sometimes, droopy eyelids partially or fully block your vision or cause double vision (called diplopia).

MyMSTeam Members Discuss Droopy Eyelids

A number of MyMSTeam members post about their droopy eyelids. “Droopy eyelid?” wrote one member, looking for others with the symptom. “Mine has started the past couple of weeks on the left eye.” Another member asked, “Does anybody else have issues with one droopy eye?” A third member answered in the affirmative and said, “My left eyelid is droopy and my vision is blurry.”

Other members report that both of their eyelids droop. “Does anyone else experience droopy eyelids?” one MyMSTeam member asked. “My doc says my eyelid muscles have been affected. I look like I am half asleep.”

Some members have noticed how droopy eyelids can pair up with other symptoms, like seeing double. “For the last couple of weeks, I have noticed my vision changing,” wrote one MyMSTeam member. “I went to the eye doc and got a prescription for some glasses. A couple days later, I noticed my vision was doubled and my left eyelid was drooping.”

On the other hand, some MyMSTeam members don’t even notice their ptosis. “Well, I have a droopy eyelid and did not know it,” one member explained. “My neuro-ophthalmologist said I have it in my left eye.”

What Causes Droopy Eyelids in Someone With MS?

Nerve cells (neurons) have a protective coating around them called myelin that helps send signals to the brain. When the myelin sheath gets damaged, this causes demyelination. Demyelination that appears in the central nervous system (CNS) serves as a hallmark of MS and is responsible for ptosis. How? It disrupts the nerve signals from the brain to the muscles that control the eyelids, causing them to droop.

What Else Causes Droopy Eyelids?

The known causes of ptosis relate to the nerves or muscles (or both) that control your eyelids. And ptosis can come from conditions besides MS, too. Since people diagnosed with MS can also experience other conditions, let your healthcare team examine any newly drooping eyelids or those that worsen. Getting a definitive diagnosis for your change in symptoms could mean a visit to a neurologist or a specialist ophthalmologist.

Other conditions that can cause ptosis include:

• Myasthenia gravis
• Diabetes
• Tumors
• Horner syndrome
• Styes or other swelling in the eyelid
• Vascular problems

A droopy eyelid may also be associated with a stroke. Get immediate medical attention if your droopy eyelid happens very rapidly and/or alongside these symptoms:

• General confusion
• Difficulty speaking
• Problems understanding others
• Sudden weakness or numbness occurring on one side of the body, on the face, leg, or arm
• Problems with coordination
• Vision problems
• Sudden, severe headache

Managing Droopy Eyelids With MS

In people with MS, where it is shown that the ptosis is longstanding and not due to other causes, there may be some corrective options available. If ptosis affects your vision or the change in your appearance bothers you, talk to your doctor. Your treatment will depend on the severity and whether it’s related to problems with nerves or muscles. Generally, treatment options include surgery or eye drops.

Surgery

In some cases, surgery proves to be the best option to treat ptosis. If your healthcare provider recommends surgery, they will determine the best type for you. They’ll likely take into consideration the cause and severity of your ptosis to determine the type of surgery.

After their surgery, one MyMSTeam member said, “I had ptosis (droopy eyelid) surgery last Friday, and my eyelids still hurt! I’ve gone from dark purple to dark blue, green, rainbow, and now yellowish green. My vision is still blurry, and my eyes are swollen. My nose, under eyes, and cheeks are swollen as well. I had this done because my eye doctor said it was medically needed — I was seriously losing my peripheral vision.”

Eye Drops

There are prescription eye drops that target the eye muscles to help with certain kinds of ptosis. The drops have to be used daily to see improvement. However, these eye drops don’t usually help those with nerve-related eye drooping.

Find Your Team

MyMSTeam is the social network for people living with multiple sclerosis and their loved ones. On MyMSTeam, members come together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.

Do you experience ptosis with MS? How do you manage your symptoms? Share your experience in the comments below, start a conversation by posting on your Activities page, or connect with like-minded members in Groups.