Ptosis or blepharoptosis is commonly known as drooping eyelid. It is caused by a weakness of the levator and Müller’s muscles ¹, which are responsible for opening the eyelid. One or both eyelids can be afected. It is most common in the elderly, however one can be born with ptosis or it can be caused by nerve damage from trauma, diabetes, stroke, cancer or myasthenia gravis. The main symptoms include drooping of one or both eyelids and increased tearing. If the ptosis is severe, amblyopia can develop. Diagnosis is made visually. The patient will ofen present with an elevated eyebrow and contraction of the muscles in the forehead to compensate for the weak levator muscle. If the ptosis is bilateral, patients may also raise their chins to help them see. Tests may be needed to confrm metabolic or immunological conditions.

Since the majority of cases are related to aging, there is no Western medical treatment; however, if the ptosis is severe enough to interfere with vision, surgery should be considered. Blepharoplasty, an eyelif, can also be performed to improve the patients’ appearance. If the ptosis is congenital, surgery may be indicated to prevent amblyopia. If relevant, there will also be treatment specifc to the underlying medical condition.

In TCM, this disease is referred to as shàng bāo xià chuí (上胞下垂, drooping of the upper eyelid), also known as zhuī mù (睢目), qīn fēng (侵风), and in severe cases, jiăn fèi(睑废). It results in narrowing of the palpebral fssure, which can partially or entirely cover the pupil. It can be divided into two categories: pre-natal and post-natal.

The possible etiologies of this condition are numerous. A defciency of pre-natal essence leads to kidney fire and spleen yang deficiency, which in turn results in hypoplasia of the palpebral muscle. Palpebral weakness then results in a failure to lif the eyelid upward. Spleen qi sinking, with an inability of clear yang to rise, results in palpebral dystrophy and, again, a failure to lift the eyelid. Furthermore, spleen defciency leads to damp accumulation and phlegm formation. When coupled with invasion of external wind pathogen, it results in wind phlegm blocking the collaterals, leading to wasting of the palpebral sinews causing ptosis.