Drooping eyelids

Definition - what are drooping eyelids?

Drooping eyelids are a disease of the upper eyelids that usually occur in old age.
Changes and weaknesses in the connective tissue and additional fat deposits in the upper eyelid lead to the upper eyelids sagging.
This appearance of the eyelids is called drooping eyelids.
The equivalent to this on the lower eyelid are the so-called bags under the eyes, which can also lead to changes in the eyelids due to weak tissue.

Read about the best way to remove puffy bags under the eyes:
Eliminate swollen bags under the eyes

Causes of drooping eyelids

The causes of drooping eyelids can usually be found in old age.
With increasing age, the connective tissue, which often serves as a kind of support in the tissue and keeps it in shape, becomes weaker.
This favors the development of drooping eyelids and bags under the eyes, but is also noticeable in many other parts of the body.

Other causes of drooping eyelids can be processes that promote the aging of body tissues in general.
These include lack of sleep and stress with a lack of regeneration for the body and mind as well as the excessive consumption of harmful substances such as alcohol, nicotine and drugs.
The skin ages prematurely due to the stress hormones and harmful substances.
This is also noticeable in the supporting connective tissue and leads to a greater "slackness" of the connective tissue, which promotes drooping eyelids.

But hormonal diseases such as the malfunction of the thyroid gland can cause changes in the eyes and eyelids.
Likewise, the increased release of stress hormones through dysregulation in the brain or in the adrenal cortex can lead to early damage to the skin, which also favors the drooping eyelids.

Also read about how you can reduce stress in order to reduce drooping eyelids:
How to reduce stress!

How can you remove drooping eyelids without surgery?

Drooping eyelids can best be removed without surgery if a clear cause can be found.
In the case of hormonal disorders, for example, drug therapy can be used to bring the hormonal balance back into balance.
This includes, for example, the therapy of thyroid dysfunction.
Once the hormonal cause has been eliminated, the drooping eyelids usually recede at least to a certain extent.

Drooping eyelids as a result of excessive substance consumption can also be improved again through abstinence.
If the eyelid changes are due to lack of sleep and / or excessive stress, relaxation procedures and proper sleep hygiene can improve the symptoms. In addition, age-related drooping eyelids can be treated to a certain extent without surgery.
Various home remedies and moisturizers are used to strengthen the skin and the underlying connective tissue.

Another therapy option, which is not permanent, is the use of tapes for the eyelids. These can lift the drooping eyelids and thus enlarge the field of vision again.

Which home remedies can help?

For drooping eyelids, home remedies similar to those used for wrinkles are usually used, as the mechanism behind these complaints is usually due to a weakening of the connective tissue.
Especially skin care creams that donate a lot of moisture can therefore be used well.
Plaster strips and tapes can also be used to counteract the visual field restrictions caused by the drooping eyelids.
This is glued to the lower part of the eyelid and above the eyelid, which lifts the upper eyelid slightly.

What can be expected from laser therapy?

The lasering of drooping eyelids is a relatively new treatment method for drooping eyelids.
The originally used scalpel is replaced by a laser scalpel.
The technique initially used was that the cut on the eyelid, which was previously made with a scalpel, is now carried out using a laser technique.
The great advantage of this is the increased precision through computer-modeled work.

Most of the time, the excess tissue was surgically removed from the eyelid.
In the meantime, however, this step can also be replaced by the laser scalpel, so that tissue removal can also be carried out using laser therapy.
Here, too, the laser can ablate much thinner layers than the conventional hand-guided scalpel, so that more precise interventions on the eyelid are possible.

The disadvantage of laser therapy is often the higher costs.
The operating doctors and clinics have to purchase the laser devices, which are usually significantly more expensive than individual scalpels.
With increasing innovation in the field, however, laser technology will probably become a little cheaper in the future.

What do tapes do against drooping eyelids?

Tapes and plaster strips are also popular aids for drooping eyelids.
With the help of the adhesive strips, the eyelid is gathered so that it no longer hangs down.
This primarily results in an improvement in the field of vision, as the drooping eyelid no longer hangs down so much in front of the eye.
A permanent therapy of the drooping eyelids is not possible with tapes.
Instead, the adhesive strips must be renewed regularly.

The cosmetic result is usually not completely satisfactory with the tape strips either. Therefore, tapes against drooping eyelids are often classified as a temporary solution, especially for younger sufferers, before deciding on permanent therapy.
However, those who mainly suffer from the functional limitations of the drooping eyelids and want to avoid an operation can usually work with the tapes against drooping eyelids over a long period of time.

How Much Can Creams Help?

Creams are used in the therapy of drooping eyelids primarily to support the skin and tissue.
Often aging processes and hormonal influences are the reason for drooping eyelids. The active ingredients contained in the creams can counteract these processes and thus strengthen connective tissue and skin. For this purpose, nourishing creams that donate moisture are mainly used.
This contributes to a better regeneration of the tissue and thus slows down the structural changes on the eyelids.
Usually, however, the nourishing creams are not a permanent solution for the treatment of drooping eyelids.

Can hyaluronic acid help?

Hyaluronic acid is an active ingredient that is said to give the various tissues of our body more strength and structure.
Since the drooping eyelids are often based on weak connective tissue, hyaluronic acid can help against drooping eyelids.
However, depending on how strictly they have been tested, different products are different in their effectiveness and side effect profile.

The hyaluronic acid preparations are often not subject to the strict tests of the Medicines Act and should therefore be selected with caution.
Nevertheless, there are many preparations that can relieve the symptoms of drooping eyelids over a longer period of time.

Why can visual field restrictions occur?

Visual field restrictions can often occur in the context of drooping eyelids.
The reason for this is that especially when looking up, the eyelids can no longer be lifted far enough.
This causes the pupil to move faster behind the eyelid, preventing a clear upward look. How severe the visual field restrictions are can be determined using what is known as visual field perimetry.
Optical signals (mostly lights) are displayed in a certain area and must be recognized by the person concerned.
In this way, parts of the field of vision that can no longer be seen can be quickly located and narrowed down.

Operation of drooping eyelids

After exhausting other therapeutic options (therapy of hormonal diseases, stress reduction, renouncing alcohol, nicotine, etc.), the operation is the method of choice to remove drooping eyelids in the long term.
A cut is made under local anesthesia in the crease of the eyelid using a scalpel or laser.
This cut can remove excess tissue from the eyelid. Usually, fat and muscle tissue is removed first, then the skin of the eyelid is tightened.
The incision can then be sutured again, ideally this is done so that the resulting scar lies precisely in a natural fold of the eyelid.
In this way, the operation can be carried out without any cosmetic restrictions.

However, an operation carries risks.
For example, pain, swelling and bleeding can occur, and some people are allergic to the anesthetic.
In addition, structures directly on the eye can be injured, which in the worst case lead to blindness.
Excessive scar tissue formation can worsen the aesthetic result.

Overall, however, the operation of the drooping eyelids is a frequently performed and proven treatment method, so that complications rarely have to be expected.

You can find out which invasive and non-invasive methods there are for an eyelid lift here:
Operate drooping eyelids - you should know that! or Eyelid lift - these forms of therapy exist

What does an operation cost?

An operation costs between a few hundred euros and up to 2500 euros, depending on where it is performed.
The type of intervention (classic operation with scalpel vs. laser technology) plays a role as well as the size of the operation (only drooping eyelids, possibly plus bags under the eyes and / or lifting of the eyebrows).
If an operation occurs due to a medical indication such as a restricted field of vision or the eyes drying out, the health insurance company will cover the costs for the standard operation.
Drooping eyelid operations for purely aesthetic reasons, on the other hand, have to be paid for by the affected persons themselves.
Ideally, the health insurance company should be consulted before the operation to clarify whether the costs will be covered.
This applies in particular to affected persons with private health insurance or private supplementary insurance.

How long do drooping eyelids last?

Drooping eyelids can often remain for a long time, depending on their treatment.
If the underlying causes are treated successfully, they can regress within weeks to months.
Home remedies and creams can also promote regression of the drooping eyelids, but they usually reappear after a certain time.

An operation on the drooping eyelids (usually one to three hours) promises permanent improvement, but in this case too, the drooping eyelids can reappear due to the further structural deterioration of the connective tissue and the skin.

accompanying symptoms

In addition to aesthetic restrictions due to drooping eyelids, this disease can also have more serious consequences for the eye and its function.
Strong, drooping eyelids can be in the area of ​​the so-called optical axis.
In this case, they prevent the light rays from falling through the pupil from a certain area of ​​the field of vision into the inside of the eye and thus restrict the view in a certain direction (most often at the top outside).
The severity of the restriction can be determined using the visual field examination (perimetry).
In addition, drooping eyelids can prevent the eyes from being completely closed.
As a result, the eyes dry out more easily, as less tear fluid can be held on the surface of the eye.
This leads to the feeling of dry eyes, which often sting, but can also be structurally damaged.

For example, the tear film also serves to protect the cornea and conjunctiva.
Drying out the eye can damage the individual structures in the eye, which in turn can lead to impaired vision, for example in the form of blurred vision.


The diagnosis of drooping eyelids can usually be made on the basis of the clinical picture; precise examinations are initially not necessary for the first diagnosis.
However, the various causes of drooping eyelids should be carefully investigated so that any underlying malfunctions of hormonal systems can be treated and / or the consumption of harmful substances can be limited.

In addition, a precise diagnosis of the drooping eyelids also includes an overview of the functional limitations caused by the misalignment of the eyelids.
For example, the visual field should be checked.
In addition, it should be checked whether the eyes run the risk of drying out due to the drooping eyelids.