Ptosis is common with aging, although it may be congenital or neurological. It is often bilateral. Symptoms include strain, headache, difficulty keeping eyes open when tired or reading. Signs include frontalis muscle overaction, eyelids within 2mm of pupil centre and chin up position if severe.

Repair is done in day surgery under local anaesthetic with intravenous sedation. Surgery is bilateral when required, levators are advanced and reattached to the tarsi. With the patient awake eyelid height can be adjusted at surgery.