Ptosis correction surgery - a lid that sits where it should.

Prices vary by hospital, by the consultant and by whether upper-lid skin removal is combined at the same sitting. The NHS funds functional ptosis - typically an MRD1 of 2 mm or less with a documented visual-field defect - with waits commonly nine to eighteen months; purely cosmetic droop is not funded.

• Age-related aponeurotic droop

  The most common reason. The levator tendon stretches or slips off the tarsal plate with age or contact-lens wear, and the lid slowly falls over the pupil.

• Visual axis obstruction in daily tasks

  The lid crosses the pupil, cutting your top field. You tip your chin up to read the road signs, or lift the brow to see the computer.

• Congenital ptosis carried into adult life

  A lid that has always sat low, often with a poorly developed levator. Correction is usually a frontalis sling, occasionally a large levator resection.

• Post-cataract or post-injection droop

  A common complication of eyelid speculum use, intravitreal injections and long cases under peribulbar block. Often settles by six months - if not, it is fixable.

• Contact-lens related aponeurotic ptosis

  Decades of hard-lens or repeated soft-lens wear stretches the tendon. Often bilateral, often asymmetric, and often the first thing that makes patients look tired.

• Cosmetic asymmetry after blepharoplasty

  A lid that looks low after upper-lid skin removal usually needs the underlying ptosis addressing - skin alone was never the problem.

• Brow strain, forehead ache and eye fatigue

  Constant frontalis lifting causes forehead ache by mid-afternoon. Correcting the lid takes the load off the brow.

• Red flag: sudden droop, double vision or pupil change

  A new droop with double vision, a fixed dilated pupil or headache is a same-day neurology or A&E problem - not a cosmetic clinic booking. Third-nerve palsy and posterior communicating artery aneurysm sit in this differential.

• Almost always under local anaesthetic

  You sit up during the operation so the surgeon can check the lid height on the table. Light sedation is available if you prefer, but general anaesthetic is reserved for children and long combined cases.

• Bruising, swelling and blurred vision for a few days

  Expect a purple lid for a week and blurred vision from ointment for two or three days. Ice for 48 hours, head elevated, sleep on two pillows.

• Asymmetry is the most common issue

  A millimetre either way is normal at week one, usually settles by three months. Around 5–12 percent of adult cases need a small revision - covered by our twelve-month policy.

• Dry eye and lagophthalmos

  A lifted lid closes slightly less well at night for a few weeks. Preservative-free tears by day, lubricating ointment at night. Ask about pre-existing dry eye before we plan surgery.

• Infection, bleeding and scarring are rare

  Wound infection under 1 percent, orbital haematoma under 0.1 percent. The skin-crease scar fades to a fine line by three months in almost every patient.

• Over-correction and under-correction

  An over-lifted lid can cause exposure keratopathy; an under-lifted lid keeps the problem. Sitting up on the table brings both risks well below 10 percent.

• Contour irregularity and lash ptosis

  A peaked or flat contour, or lashes that turn down, are the aesthetic problems we watch for. Both are correctable at a small revision if they do not settle.

• Loss of vision - vanishingly rare

  Retrobulbar haemorrhage with vision loss is reported at less than 1 in 10,000. Sudden severe pain, worsening vision or a very proptosed eye needs same-day contact.

• Red flags after surgery

  Severe pain, spreading redness, sudden vision loss, a very swollen or hard eye or a fever above 38°C need the on-call team or A&E, not a routine call.