Bilateral ptosis (diagnosed) my whole life…can this be normal?

[Spartan114]

26 male, one eyelid is a bit droopier than the other and always has been so I mentioned it to my ophthalmologist at my last appointment. He took out some tool and measured some things and said BOTH my eyelids are considered droopier than normal and suddenly started bringing up all kinds of musculoskeletal skeletal conditions etc (I have stretchy fingers he noticed which set him off) anyway he referred me to neurology. I was nervous but then neurology was baffled why I was even there. The neurologist said lots of people have clinical ptosis but it’s just their ‘default settings’ with no underlying issue or malfunction of anything. They still looked me over and we’re polite but ultimately said my eye doc had really overreacted.

My question is if this is true? Do some people just have ptosis right out of the gate? I do have very almond shaped eyes and I should note my grandfather was recommended to get tissue removed from his eyelids because it got to the point they drooped his down pretty bad as he got old, he never did and never had any issues. His son, my uncle DID have a procedure to remove some tissue there because his eyelids started to droop. My father was younger and is no longer with us on this earth, however in pictures he and I (and my grandfather) all have very almond shaped eyes with relaxed looking eyelids.

Is this just a generic trait for some people or is this usually tied to some level of malfunction?

[John C Hagan III, MD, FACS, FAAO]

If the droopy eye lid (Ptosis) was present from birth it is called "congential ptosis"   it can affect one or both eyes. Some times the eyelid hangs down so much it blocks vision and would cause poor vision in the eye (amblyopia) so surgery is required to hike up the lid.  If it is mild and does not block the vision and as the person ages does not bother them or have impaired peripheral vision it can be left along, it it bothers then it can be repaired as an adult.    NOW THIS IS IMPORTANT:    If a prson is born with no droopy eyelids and the develop as child or young adult a full neuro workup like you got is indicated looking for rare problems like Myasthenia Gravis or Horner's Syndrome.   AS WE AGE OUR EYELIDS DROOP LIKE THE REST OF US.   Sometimes this can be worse on one eye or the other.  The droopy look can be due to excess baggy eye lid skin and is not true ptosis.  The excess skin and fat can be removed to improve peripheral vision or for cosmetic reasons.  This is the most common thing in aging.   Sometimes the lid is truly lower, if this comes on suddenly once again a neuro work up is indicated.   Congential ptosis can show some heriditary traits but the other kind is just aging.  

[Spartan114]

Interesting. Is congenital ptosis hens teeth rare or just a thing that happens sometimes?  I’m an oddity because I see an ophthalmologist regularly at my age but I see people all the time with eyelids that look droopier than mine my age or younger even so I feel like it can’t be exceptionally rare and others just don’t seek evaluation for something they’ve always had you know? Mine is hardly noticeable but just one is ever so slightly lower than the other.

Neuro did the finger test for myasthenia gravis and other stuff as well. They were thorough and polite but one even pointed to his eyelid and said he had ptosis he never had evaluated and wouldn’t that be embarrassing for a neuro to have something undiagnosed right there.

I should note my eye doc has mentioned my eyes measurements interesting in that they are normal latitude wise but longitudinal they are a decent bit longer than what is average. He said that’s not a bad thing in anyway just a trait.. would that affect how my eyelids work? Just trying to understand why I would have this ptosis. I take it the family explanation doesn’t make sense for me since their s was the whole tissue removal deal?

[John C Hagan III, MD, FACS, FAAO]

I'm sorry at this point you will need to read about it. I've answered your question about you.