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    Droopy eyelid
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    An_250204 posted:
    I am a 32 year old male with what I consider a good healthy diet. I haven't had red meat or pork for about 10 years, and I maintain a good exercise routine.
    Less than a week ago, my left eyelid started twitching and as of a couple of days my eyelid has gotten droopy. I've also gotten headaches (I'm not sure if the headaches are the cause to my droopy/lazy eye lid) and my eye just feels swollen, but its not. I visited my general doctor and he recommended an MRI. This morning, I got a call with my results and everything checks out clear. So if there's nothign wrong as of now then why is this happening to me? Please let me know whats causing my lazy eyelid.
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    Ansulew responded:
    I'm not sure, but try to check into an oculoplastic eye doctor. They know details about the eye lids, tear ducts and the orbits of the eyes. They also do plastic surgery, but who knows if that is necessary?? I had a blocked tear duct for a long time, and an oculoplastic eye doctor flushed my tear ducts with saline solution, and that helped me. At least the doctor could give you insight as to what could be happening.
     
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    Alan M Kozarsky, MD responded:
    I am sorry that you are having problems.

    Twitching of the eyelid is a common symptom which is nearly always harmless. It will usually resolve after a few days or weeks.

    On the other hand, relatively sudden drooping of the eyelid, a condition that we call ptosis, especially in a young person, is much more suggestive of a neurological condition. There are two systems of nerves which keep the eyelid open and if there is an interruption of either nerve pathway, the eyelid will droop.

    The eyelid can also droop on the basis of conditions which affect the muscles which keep the eyelid in a normal an elevated position. An example of such a condition is myasthenia gravis.
    The concern for a neurological condition is increased if you have a new onset of headache which started at the same time as a drooping eyelid. A normal MRI is good news but this does not look at all of the nerve pathways and the MRI can't "see" very small abnormalities of the blood vessels which surround the nerves which keep the eyelid normally elevated.

    With all of this said, the best doctor to evaluate this situation would be a neuro-ophthalmologist. This is a doctor trained in both neurology and ophthalmology. You can find one by going to www.AAO.org and selecting "Find an Eye MD" from the top tabs and then searching for a specialist in "Neuro-Ophthalmology". If one is not available in your area, the second choice would be a neurologist.

    Because of all of the possibilities including some that require immediate diagnosis and treatment, I would make the appointment today.


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