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What is
acquired ptosis?

Are drooping eyelids making your eyes look tired?
You might have acquired ptosis. This condition, also known as acquired blepharoptosis, can be caused by aging, trauma, muscle weakness or stretching, or nerve damage. Understanding its causes, symptoms, evaluation, and treatment options is crucial for managing it effectively.

Causes
of acquired ptosis

In many cases, acquired ptosis is the result of natural aging as your eyelid muscles stretch and weaken over time. However, ptosis (eyelid drooping in one or both eyes) can sometimes be caused by more serious conditions, including stroke, brain aneurysm, Horner syndrome, myasthenia gravis, and eye infections. You should seek additional medical evaluation if you or your doctor suspect any of these more serious conditions.

Understanding acquired ptosis

Acquired ptosis involves the sagging of the upper eyelid, leading to a partially obstructed field of vision. People can experience mild, moderate and severe forms of acquired ptosis. Unlike congenital ptosis, which is present from birth, acquired ptosis develops later in life due to factors such as:

  • 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.

DEGREES OF ACQUIRED PTOSIS

Normal ptosis

Normal

Mild ptosis

Mild

Moderate ptosis

Moderate

Severe ptosis

Severe

Symptoms of acquired ptosis

The severity of symptoms can vary but may include:

One eyelid drooping lower than the other.
Difficulty keeping your eye open.
Eye strain or fatigue.
A feeling of heaviness in the eyelid.
Close-up of an eye with ptosis

In severe cases, vision may be obstructed, making activities like reading or driving challenging. The condition can also affect appearance, creating an asymmetrical or tired look, and complicate makeup application or contact lens wear.

Evaluation and diagnosis

Proper evaluation and diagnosis are vital for detecting and understanding acquired ptosis. This process typically involves:

Medical History

Discussing underlying conditions, trauma, autoimmune disorders, or neurological diseases with your healthcare provider.

Physical Examination

Assessing eyelid position, symmetry, and movement, along with visual acuity, eye movement, and pupillary reactions.

Special Tests

Conducting tests like the levator function test to measure the strength of the levator muscle.

Treatment
and management

For many patients, acquired ptosis, often called "low-lying eyelid," can be managed through non-surgical and surgical options depending on severity and underlying cause.

Non-Surgical
Treatments


  • Prescription Eye Drops: Oxymetazoline hydrochloride ophthalmic solution, 0.1% can temporarily lift the eyelid and improve vision.
  • Specialized Eyeglasses: Glasses with a built-in eyelid crutch can help.
  • Adhesive Tape: Tapes or strips can be used to lift the eyelid, although they may not be suitable for everyone.

Surgical
Treatments


When non-surgical options aren't effective, surgical procedures like blepharoplasty may be considered. This involves tightening the levator muscle and possibly repositioning or removing excess skin or fat.

Low-lying eyelids

Do you have low-lying eyelids?

Please note that this is for preliminary self-assessment only. See a healthcare provider or aesthetic professional, so they can accurately diagnose your type of low-lying lids.

PREVENTING ACQUIRED PTOSIS

While causes can vary, some preventive measures can help reduce the risk

For those with acquired ptosis, using artificial tears or lubricating eye drops can alleviate dryness and discomfort. Adjusting posture, using a higher pillow while sleeping, and performing recommended eye exercises can also be beneficial.

Regular Eye Exams
Regular Eye Exams

Early detection of ptosis.

Eye Protection
Eye Protection

Wearing appropriate protection during risky activities.

Proper Eye Hygiene
Proper Eye Hygiene

Washing hands before touching eyes or applying makeup, and not sharing cosmetics or tools.

Future prospects
and research

Ongoing research aims to better understand acquired ptosis and develop new treatments. Advancements in imaging techniques and diagnostic tools are helping during the evaluation and diagnosis process.

Patients who think they may have acquired ptosis should consult with their doctors about what treatment option(s) may be right for them.

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 agonist 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.

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 agonist 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.