What to Know About Acquired Blepharoptosis and Tired-Looking Eyes
You got a full night’s sleep, but your eyes are telling a different story. While there are plenty of reasons eyes can look tired, one that often goes overlooked is a condition called acquired blepharoptosis, or low-lying eyelids. Here’s what you should know.
What is acquired blepharoptosis?
Acquired blepharoptosis—also known as low-lying eyelids—occurs when one or both upper eyelids gradually begin to sit lower than they normally would. The change can be subtle or become more pronounced over time, and it may affect one eye more than the other.
Acquired blepharoptosis can develop later in life, and while aging can play a role, there are several reasons it can occur.
What causes acquired blepharoptosis?
There isn’t one single cause of acquired blepharoptosis. Age-related changes are one potential factor, but there are several other reasons it can develop, including:
- Age-related weakening/stretching of the levator muscle, which lifts the eyelid.
- Trauma to the eye or eyelid.
- Nerve damage.
- Complications from eye surgery.
- Long-term contact lens wear (particularly rigid contact lenses).
- Side effects from wrinkle reduction injections.
What are the signs of acquired blepharoptosis?
Acquired blepharoptosis can look and feel different from person to person. Some signs you may notice include:
- One eyelid sitting gradually lower than the other
- Difficulty keeping one or both eyes fully open
- Eye strain or fatigue
- A feeling of heaviness in the eyelid
If you notice a new or changing difference in your eyelids, it’s important to talk with a healthcare provider, who can help determine what may be causing it. Eyelid drooping can also be associated with other serious medical conditions such as stroke, brain aneurysm, Horner syndrome, myasthenia gravis, and eye infections. You should seek additional medical evaluation if you or your doctor suspect this may be what you’re experiencing.
How is acquired blepharoptosis diagnosed
A healthcare provider can help determine whether acquired blepharoptosis may be causing changes in your eyelids. They’ll typically ask about your medical history and any changes you’ve noticed, then examine your eyelid position and movement. They may also evaluate your vision and eye movement to help determine what’s causing your symptoms to rule out other potential conditions.
When to speak to your healthcare provider?
If you notice a change in the position of one or both of your upper eyelids, it’s worth bringing it up with a healthcare provider. This is especially important if the change is new or sudden, affecting your vision, or interfering with your daily activities.
A healthcare provider can help determine what’s causing the change and whether further evaluation or treatment may be appropriate.
What treatment options are available?
Treatment for acquired blepharoptosis depends on what’s causing it, how severe it is, and how it’s affecting you. A healthcare provider can help determine which approach may be appropriate.
Non-surgical treatment
- For some adults, a prescription eye drop may be an option. Upneeq® (oxymetazoline hydrochloride ophthalmic solution), 0.1% is an FDA-approved once daily eye drop for adults with acquired blepharoptosis (or low-lying eyelids). Upneeq provides a non-surgical eyelid lift, quickly lifting eyelids in minutes, with results lasting up to 8 hours, for more open and awake-looking eyes. A healthcare provider can help you determine whether Upneeq is a good fit, and virtual consultations are also available at upneeq.com
See below for Important Safety Information for Upneeq.
Surgical treatment
- If non-surgical options are not right for you, a doctor may recommend an eyelid surgery called a blepharoplasty. This surgical procedure tightens or repositions the levator muscle that holds your eyelid open, depending on your unique situation.
The takeaway
If your upper eyelids seem to sit lower than they once did, don’t automatically chalk it up to being tired. Acquired blepharoptosis is a medical condition that can develop later in life, and treatment options are available.
If you’ve noticed a gradual change over time in your eyelids, talk with a healthcare provider about what next steps may be right for you.
Important Safety Information
What is UPNEEQ?
UPNEEQ® (oxymetazoline hydrochloride ophthalmic solution), 0.1% is a prescription eyedrop used to treat acquired blepharoptosis (low-lying lids) in adults
What warnings and precautions are associated with UPNEEQ?
- Low-lying lids may be related to conditions such as stroke and/or brain aneurysm, Horner syndrome, myasthenia gravis, loss of the ability to move eye muscles, eye infection and eye tumors. Tell your doctor if you have any of these conditions.
- UPNEEQ is a type of medication that may affect your blood pressure. If you have heart disease, uncontrolled high or low blood pressure, or feel faint at rest or when quickly standing up, you should call your doctor if your symptoms get worse.
- Patients with reduced blood flow to the brain or heart, or patients who experience eye or mouth dryness due to an immune system disorder (Sjögren’s syndrome), should use care when taking UPNEEQ. Call your doctor immediately if you feel your symptoms may be getting worse.
- UPNEEQ may increase the risk of eye pressure due to fluid buildup (angle-closure glaucoma) in patients with untreated narrow-angle glaucoma. Call your doctor immediately if you feel increased pressure in your eye after using UPNEEQ.
- Do not let the tip of the UPNEEQ vial touch your eye or any other surface. This can help prevent eye injury or contamination. Each UPNEEQ vial is for one-time use and should be discarded after being used.
What are the most common side effects of UPNEEQ?
The most common adverse reactions with UPNEEQ (occurring in 1–5% of patients) were eye inflammation, eye redness, dry eye, blurred vision, eye pain at time of use, eye irritation, and headache.
What should my doctor know about before prescribing me UPNEEQ?
- Your doctor should review your full medical history before prescribing UPNEEQ.
- UPNEEQ belongs to a class of medication (alpha-adrenergic agonists) that may affect your blood pressure. Use UPNEEQ carefully if you currently take an alpha-adrenergic antagonist medication to treat heart disease or an enlarged prostate. Patients taking beta-blockers, or other medications to treat hypertension or an abnormal heartbeat, should also be careful when using UPNEEQ.
- Patients who use a certain class of antidepressant medication (monoamine oxidase inhibitors) should also be careful when using UPNEEQ, as it may affect the way your body absorbs the medication.
These are not all of the possible side effects of UPNEEQ. Tell your doctor if you have any side effect that bothers you or does not go away. Call your doctor for medical advice about side effects.
To report side effects or product complaints, contact RVL Pharmaceuticals at 1-877-482-3788. You may also report side effects to the FDA by calling 1-800-FDA-1088 or visit www.fda.gov/medwatch.
This is a summary of the most important safety information for UPNEEQ. For more in-depth safety information, please review the full Prescribing Information for UPNEEQ.
Upneeq® is distributed by RVL Pharmaceuticals, Inc., Bridgewater, NJ 08807.
Upneeq® is a registered trademark of RVL Pharmaceuticals, Inc.