Sagging Eyelids Can Make You Look Older and Affect Your Vision

Over time, our skin stretches, sags, creases, and folds. While it’s a natural effect of aging, it can be a medical problem when it happens to our eyelids. That’s because sagging upper eyelids can severely limit peripheral or side vision.

Fortunately, there’s medical help in the form of eyelid surgery. Known by the medical term, blepharoplasty, eyelid surgery is an outpatient procedure that removes excess tissue and lifts the skin. At Atlantic Eye Center, it’s a procedure done without a knife.

“We use radio frequency to excise the excess skin, not a scalpel,” stated Dr. Michael Caruso, ophthalmic physician and surgeon at Atlantic Eye Center. “That’s an important distinction because there is little to no bleeding.”

The Causes of Sagging  Upper Eyelids

There are various causes for sagging upper eyelids. There may be a family genetic predisposition. Sometimes, lifestyle and your environment can be a cause too. For example, people who have worked outside for years may experience drooping eyelids.

Age is another contributing factor.  Over the years, the movements that we make with our eyes—blinking, squinting and facial expressions — take their toll. Facial aging starts with the “crow’s feet,” wrinkles on the side of the eyes.

The wrinkles start to extend across the lower eyelid and into the upper eyelid. The skin then becomes lax as the muscles weaken. Eventually, the eyes have a hooded appearance. The lower lids also sag, creating “permanent” bags, causing the person to appear tired.

You may not notice that sagging upper eyelids interfere with your vision. It is a gradual process that happens over time.

Diagnosis and Treatment

Most patients request their lids be corrected because their eyes look closed and tired. They also are losing their superior visual fields. This is described as hooding. They may mention that the skin on the upper lid presses right on their lashes.

Dr. Caruso will conduct a visual field test “with and without tape.” It’s a map of the peripheral vision using a machine that measures the visual field.  

Patients are tested twice. The second time, the lids are taped, simulating post-surgical results. Dr. Caruso also takes ocular photos of the eyes, individually and together.

If sagging upper eyelids is diagnosed, the office contacts the patient’s insurance to get clearance for eyelid surgery. Insurance will cover the operation, as long as the problem is interfering with a patient’s vision.

The surgical procedure is brief, taking about 20 minutes to complete. Patients are sedated, and require transportation home. A degree of swelling is normal. Patients are given an antibiotic ointment and instructions for applying an icepack. They typically return to normal activities within a couple of days.  White dissolvable sutures are used, minimizing scarring. There is a post-op appointment five to seven days following the procedure, then a second post-op appointment is done to evaluate the final results. There is no pain post-op.

When Eyelid Surgery Is Not Recommended

Not everyone is qualified for eyelid surgery. Good health is a prerequisite.

Atlantic Eye Center is located at 207 Stone Harbor Blvd. in Cape May Court House. For more information or to schedule an appointment, visit or call (609) 465-1616. You can also find them on Facebook.