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Patients often come in about a drooping eyelid because of how it looks in photos. But ptosis is not only cosmetic. A lid that hangs low enough can block part of your vision, and in a young child it can affect how the eye develops.

What ptosis is

The American Academy of Ophthalmology (AAO) defines ptosis as a drooping of the upper eyelid. It can be slight, or severe enough to cover the pupil and block vision. Both children and adults can have it.

Ptosis in children

Children born with ptosis (congenital ptosis) usually have a problem with the levator, the muscle that lifts the eyelid. Signs include a droopy lid, uneven eyelid creases, and a child tipping the head back, lifting the chin or raising the eyebrows to see. The AAO warns that a lid that blocks vision can lead to amblyopia (“lazy eye”), and children with ptosis can also develop astigmatism or misaligned eyes.

Treatment depends on the child’s age, eyelid height, muscle strength and eye movements. Surgery may be recommended to improve vision, and any amblyopia must be treated too, with patching, glasses or drops. All children with ptosis need regular eye exams.

Ptosis in adults

In adults, ptosis (called acquired or involutional) usually happens when the levator muscle stretches or separates from the eyelid with age or after an injury. It can also follow some eye surgeries. Rarely, nerve or muscle diseases or tumors are the cause, which is why a complete exam comes first, sometimes with blood tests or imaging.

Treatment options for adults

• Surgery is the usual treatment. It is typically outpatient, with local anesthesia. Mild cases may need only a small adjustment of the lifting muscle; more severe ones may need the muscle shortened and reattached.
• Prescription drops. The AAO notes a daily drop, oxymetazoline, can lift the lid somewhat in some adults with acquired ptosis. It must be used every day to keep working and does not help ptosis from injury or nerve problems.

Before eyelid surgery

Tell your surgeon about every medicine and supplement you take, especially aspirin, blood thinners or any bleeding problem.

When a droopy lid is urgent

A lid that droops suddenly, especially with double vision, a headache, a large pupil or weakness elsewhere, needs emergency evaluation.

Some patients notice a droopy lid around the time of cataract surgery; this cataract surgery education site explains what to expect from that operation.

If a droopy eyelid is getting in the way of your vision or your child’s, an oculoplastic surgeon can tell you what is causing it and what can be done.

Source: What Is Ptosis? (American Academy of Ophthalmology, 11/12/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Patients often ignore a small bump or scab on the eyelid for months, assuming it is a stye or dry skin. Most eyelid bumps are harmless. But one that bleeds, crusts, will not heal or slowly changes the shape of the lid deserves a closer look, because it may be basal cell carcinoma.

The most common eyelid cancer

According to EyeWiki, the American Academy of Ophthalmology’s clinical encyclopedia, basal cell carcinoma (BCC) is the most common eyelid malignancy, accounting for over 90% of malignant eyelid tumors. It is linked to ultraviolet light damage to the skin, particularly UVB.

Who is at risk

EyeWiki notes that BCC tends to occur in lightly pigmented people at sites of sun exposure, although it can occur with any skin tone. Radiation exposure is among the other risk factors listed.

Signs to watch for

• A skin lesion that does not heal
• Ulceration, bleeding or crusting
• Loss of eyelashes in one spot
• Tiny visible blood vessels on the bump
• A change in the shape or position of the eyelid

EyeWiki also notes some lesions cause no symptoms at all, which is why a doctor should examine anything that persists.

Diagnosis and treatment

BCC can be suspected on examination, but the diagnosis is confirmed with a biopsy. EyeWiki describes BCC as nearly always locally invasive, so treatment is recommended to prevent damage to nearby tissue. The standard approach is complete surgical removal with margin control, using frozen sections or Mohs surgery to make sure no cancer cells remain at the edges. A topical cream has been used in some cases but is not as effective as surgery. EyeWiki reports five-year cure rates of up to 98%.

Prevention

EyeWiki recommends minimizing sun exposure with sunblock, hats, sunglasses and protective clothing.

Who treats it

Eyelid cancer surgery and reconstruction are performed by oculoplastic surgeons and Mohs surgeons, and we refer patients when a lesion looks suspicious. If you have not had an eye exam in a while, our first visit guide explains what a comprehensive exam includes, including a look at the eyelids.

The rule I give patients is easy to remember: an eyelid spot that has not healed in a few weeks should be examined.

Source: Basal Cell Carcinoma (EyeWiki, American Academy of Ophthalmology, reviewed 9/22/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Uveal melanoma is a rare cancer that starts inside the eye. When it is found, the standard treatments come at a cost to vision: removing the eye (enucleation) or placing a radioactive plaque against it (plaque brachytherapy). A phase 2 trial is testing whether a pill taken first can shrink the tumor and make those treatments less damaging.

The drug and the trial

Darovasertib is an oral drug that blocks protein kinase C (PKC). About 95% of uveal melanomas carry mutations in genes called GNAQ or GNA11 that keep PKC switched on. In the OptimUM-09 trial, presented by Lauren Dalvin, MD, of Mayo Clinic at the 2026 American Academy of Ophthalmology meeting, patients took darovasertib twice daily before their planned treatment. As of the data cutoff, 95 patients had been treated.

What was reported

• Eye preservation. Among 42 evaluable patients who had been facing enucleation, 24 (57%) were able to keep the eye and receive radiation instead.
• Tumor shrinkage. 84% of patients in the enucleation group and 82% in the plaque group had some shrinkage.
• Lower radiation doses. In 70.3% of patients planned for plaque therapy, projected radiation to key structures such as the fovea, optic nerve or lens went down.
• Side effects. Most were low grade, such as diarrhea, nausea, fatigue and vomiting, but 26.3% had a grade 3 or higher event, and low blood pressure was among the serious ones.

What it means

No treatment is currently approved to shrink uveal melanoma before definitive therapy. These are early, single-arm results, and a randomized phase 3 trial (OptimUM-10) is under way. This is care that happens in specialized ocular oncology centers.

What you can do

• Have a dilated eye exam on schedule. Some eye tumors are found on routine exams before any symptoms.
• Report new flashes, floaters, a shadow in your vision or a change in a known freckle in the eye.
• If you are diagnosed, ask your ocular oncologist whether you qualify for a clinical trial.

Our office does not treat eye cancer. We refer patients to ocular oncology specialists. Parents who want to understand eye health for younger family members can visit a children’s eye health resource.

I share this news because it gives patients and families real hope: the goal is no longer only saving a life, but saving the eye and its vision too.

Source: Neoadjuvant darovasertib preserves eyes in primary uveal melanoma (Ophthalmology Times, 10/10/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Immune checkpoint inhibitors have changed cancer care. These medicines release the brakes on the immune system so it can attack tumors such as melanoma. But an energized immune system can also inflame healthy tissue. A systematic review from the University of Adelaide, published in November 2026, gathered what is known about one rare side effect: inflammation in the orbit, the bony socket around the eye.

What the researchers did

The team searched five medical databases in September 2026 and found 57 published reports describing 81 patients who developed orbital inflammation during or after checkpoint inhibitor treatment.

What they found

• Median age was about 66, and 63% were men. Melanoma was the most common cancer (about 41%).
• Symptoms started a median of 6 weeks after treatment began.
• The most common signs were limited or painful eye movement and double vision (70%) and bulging eyes (30%). Both sides were affected in about 3 of 4 patients.
• The eye-moving muscles were inflamed in 83%. The tear gland and the optic nerve were rarely involved.
• About 17% looked like thyroid eye disease, even though most of those patients had normal thyroid tests.
• Two-thirds had immune side effects elsewhere, most often muscle inflammation (37%) and heart muscle inflammation (24%).
• Steroids were used in 93%, and about 40% needed additional immune-calming treatment. Symptoms fully or partly resolved in 88%; about 10% had a recurrence.

The authors concluded that this side effect has a distinct pattern and that its recognition should prompt urgent, team-based evaluation, including checks for heart and muscle involvement.

What this means for you

• If you are on immunotherapy and develop double vision, painful eye movement, eyelid swelling or bulging eyes, contact your oncology team the same day and arrange an eye exam.
• Mention any new muscle weakness, chest pain or shortness of breath at the same time. These can be related and serious.
• Do not stop cancer treatment on your own. Your oncologist and eye specialists will decide together.

For readable explanations of retinal and inflammatory eye conditions, see this retina education site.

Our office refers orbital inflammation to oculoplastic and oncology specialists. Early recognition is what protects both the eye and the patient.

Source: Immune checkpoint inhibitor-associated orbital inflammation: a systematic review (Graefe’s Archive for Clinical and Experimental Ophthalmology (PubMed), 11/06/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Thyroid eye disease (TED) is an autoimmune condition, most often linked to Graves disease, that inflames the tissues around the eyes. It can make the eyes bulge (proptosis), cause double vision, and change a person’s appearance. Teprotumumab (Tepezza) was the first FDA-approved biologic medicine for moderate-to-severe TED. A new systematic review in the American Journal of Ophthalmology looked at how it performs in trials and in everyday practice.

What the review included

Researchers at Peking University First Hospital searched four databases through August 2026. They included 36 studies: 6 randomized controlled trials (4 of teprotumumab and 2 of similar medicines) and 30 real-world studies of intravenous teprotumumab in adults.

Benefits

• Eye bulging: in randomized trials, patients on teprotumumab were about 4.6 times as likely as those on placebo to have a meaningful reduction. In real-world studies, 82% of patients responded.
• Double vision: trials favored teprotumumab about 2 to 1, and 60% of real-world patients improved.

Side effects to know about

• High blood sugar: more frequent with teprotumumab in trials and seen in 17% of patients in real-world studies.
• Hearing problems: also more frequent in trials, and reported in 18% of real-world patients.

The authors conclude that teprotumumab improves bulging and double vision across study types, but that blood sugar and hearing effects in real-world use call for careful patient selection and monitoring.

If you have thyroid eye disease

• Ask whether your TED is active (inflamed) or stable; treatment choices differ.
• If teprotumumab is considered, ask about blood sugar checks, especially if you have diabetes or prediabetes, and about a baseline hearing test.
• Report ringing in the ears, muffled hearing, or excessive thirst during treatment.
• Not smoking is one of the most important steps for TED.
• Protect the eye surface with lubricating drops if your lids do not close fully.

TED is managed by oculoplastic or orbital specialists together with endocrinologists; ask your eye doctor for a referral. For more reading, see malibulasik.com.

Source: Teprotumumab for Thyroid Eye Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Real-World Studies (American Journal of Ophthalmology (PubMed), 09/29/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

How often and how completely you blink affects the tear film. A scoping review published October 5, 2026, in Eye looked at devices and apps that record and analyze blinks to help evaluate dry eye and other ocular surface diseases.

What the reviewers did

They searched PubMed, Embase, and CENTRAL from January 1, 2000, through August 17, 2025, for technologies that capture blink metrics in ocular surface disease. Engineering-only papers and tools that were not used to evaluate the ocular surface were left out. Of 3,275 records, 42 studies met the criteria. The authors compared 9 technologies: desk-bound devices (Intelligent Vision Sensor, LipiView, and IDRA), wearables (Wink Glass and Blink-sensing Glasses), and smartphone or computer applications (HealthyRoad, DryEyeRhythm, “Dry eye or not?” and EyeScore). LipiView and IDRA were the most commonly studied.

What they found

• Blink rate and partial blink rate were the metrics analyzed most often, and dry eye disease was the condition studied most often.
• In line with earlier research, studies linked a higher rate of partial blinks with a more compromised ocular surface.
• Methods varied widely, and the accuracy and diagnostic value of the measured blink parameters were not sufficiently validated for diagnosing ocular surface disease.

The reviewers concluded that these tools are promising but that more work is needed on validity, reliability, and real clinical usefulness. A blink app or camera is not a diagnosis. If your eyes feel dry, gritty, or tired, an eye exam can still look at the lids, glands, and tear film directly.

Source: A scoping review of integrated blink analysis technologies for ocular surface diseases (Eye (PubMed), 05/10/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Androgens, including testosterone, play a role in the glands that help keep the eye surface stable. A study published November 6, 2026, in International Ophthalmology looked at the ocular surface in men with androgen deficiency and at what changed after testosterone replacement.

Who was studied

The study included 77 men; only the right eye of each participant was evaluated. Thirty-seven men had testicular hypofunction, defined as a total testosterone level below 231 ng/dL. Forty eugonadal controls had testosterone above 346 ng/dL. Examinations included symptom scores (AMS and OSDI), meibomian gland grading, corneal staining, tear breakup time (TBUT), Schirmer I and II tests, tear osmolarity, and anterior-segment OCT of the inferior tear meniscus. The androgen-deficiency group received intramuscular testosterone (Sustanon 250 mg) every two weeks, and measurements were repeated at weeks 6 and 18.

What they found

• At baseline, men with low testosterone had higher AMS and OSDI scores, worse meibomian gland grades, more corneal staining, and higher tear osmolarity, and they had lower Schirmer values, shorter TBUT, and a smaller tear meniscus.
• After replacement therapy, testosterone levels rose, and AMS and OSDI scores, tear osmolarity, meibomian grades, and corneal staining improved. Schirmer tests and tear-meniscus measurements increased. TBUT also increased, but that change was not statistically significant.
• Testosterone levels correlated negatively with AMS, OSDI, and tear osmolarity, and more weakly with meibomian grade and staining, and positively with TBUT, Schirmer II, and tear-meniscus measures.

The authors concluded that androgen deficiency can affect the ocular surface, and that replacement was associated with favorable changes in several signs and symptoms in men who already needed treatment for androgen deficiency. This is not evidence that testosterone should be used as a dry-eye drug in men with normal hormone levels, and hormone therapy has its own risks that belong in a conversation with the prescribing physician. If you have known low testosterone and new dry-eye symptoms, mention both to your doctors.

Source: The effects of androgen replacement therapy on tear osmolarity and ocular surface parameters in androgen deficiency (International Ophthalmology (PubMed), 06/11/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Eye pressure, or intraocular pressure (IOP), can change while you are under anesthesia, even when the operation is not on the eye. A randomized trial published in September 2026 in Saudi Medical Journal compared spinal anesthesia with general anesthesia in adults having lumbar spine or lower-extremity orthopedic surgery.

What the researchers did

Sixty adults were randomly assigned to spinal anesthesia or general anesthesia. IOP, mean systemic arterial pressure, and heart rhythm were recorded at set times: baseline, before the spinal injection or induction, after the injection or induction, 5 minutes after the spinal procedure or intubation, 30 minutes into surgery, at the end of surgery, and 5 minutes after surgery or extubation.

What they found

• Baseline eye pressure was similar in both groups (about 14.3 mmHg with spinal anesthesia and 14.6 mmHg with general anesthesia).
• The largest drop in IOP in both groups was right after the spinal injection or induction of general anesthesia. The drop at that point was more marked in the general anesthesia group.
• After intubation, IOP was significantly higher with general anesthesia (19.82 mmHg) than with spinal anesthesia (12.86 mmHg).
• At 30 minutes and at the end of surgery, IOP stayed lower in the spinal group than in the general anesthesia group.
• Five minutes after surgery, IOP in both groups was slightly above baseline, but the difference from baseline was not statistically significant.
• In the prone (face-down) position, IOP at mid-surgery and at the end of surgery was significantly higher than at the start in both groups, and the increase was larger with general anesthesia.

The authors concluded that IOP may rise during both types of anesthesia, but the increase was greater with general anesthesia. This was not an eye-surgery trial, and it does not tell us which anesthetic is “safer” for every patient. If you have glaucoma or already-high eye pressure and are planning surgery, it is reasonable to mention that to your surgical and anesthesia team so they can take it into account.

Source: Comparison of the Effects of Spinal Versus General Anesthesia on the Perioperative Intraocular Pressure (Saudi Medical Journal (PubMed), September 2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

A droopy upper eyelid, called ptosis, becomes more common with age. One option is a prescription eye drop, oxymetazoline hydrochloride 0.1%, approved by the FDA in January 2020 for this use. A study published in Ophthalmic Plastic & Reconstructive Surgery looked at real-world side-effect reports.

What the researchers did

A team searched the FDA Adverse Event Reporting System, a database where doctors, patients, and companies voluntarily report possible side effects, from the drop’s approval in January 2020 through April 2025. They found 306 patients with 658 reported events and used standard statistical methods to look for safety signals.

What they found

• All side effects already on the label showed up, most often eye-surface irritation, red eyes, temporary blurred vision, pain on application, and headache.
• New signals not on the label included a small number of reports of retinal or vitreous problems (such as retinal detachment, floaters, or bleeding inside the eye, about 3 reports each), dilated pupils, high blood pressure, and the drop becoming less effective over time.

How to read these results

A voluntary reporting database cannot prove a drug caused a problem or tell us how often it happens; it can only flag signals for further study. The authors said more research is needed to confirm these associations. Still, it is a useful reminder that even “cosmetic-feeling” drops are real medications.

Before trying eyelid-lifting drops

• Have the cause of the droop checked. Ptosis can sometimes signal nerve or muscle conditions that need different care.
• Tell your doctor about high blood pressure, heart disease, glaucoma, or medicines that affect blood pressure.
• Report new floaters, flashes, a curtain over your vision, or headaches right away.
• For a larger droop, an oculoplastic surgeon can discuss whether surgery is a better fit.

For more plain-language reading on eye health, see bettereyesightatanyage.com.

Source: Safety Analysis of Oxymetazoline Eye Drops for Blepharoptosis Using the FDA Adverse Event Reporting System (Ophthalmic Plastic & Reconstructive Surgery (PubMed), Nov–Dec 2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

High myopia, or strong nearsightedness, is more than a need for thick glasses. High myopia is an independent risk factor for glaucoma, and it can also make glaucoma harder to diagnose. In 2026, the French Glaucoma Society and the French-speaking Retina Specialists’ Club published consensus guidelines on managing glaucoma in highly myopic eyes.

Why diagnosis is harder

According to the guidelines, high myopia adds complexity to glaucoma diagnosis, follow-up, and treatment. In some highly myopic eyes, extensive changes in the retina and the layers beneath it interfere with examining the back of the eye and with interpreting the tests used to detect glaucoma. That can make it hard to tell which changes come from myopia and which come from glaucoma.

What the guidelines recommend

• Treatment and follow-up are similar to standard open-angle glaucoma: the goal is a target eye pressure low enough to prevent new or worsening glaucoma damage.
• When eye pressure is high but the diagnosis is uncertain because of extensive myopic changes in the back of the eye, pressure-lowering treatment may be started anyway, to avoid adding glaucoma damage to the damage myopia may already cause.
• If surgery is considered, the higher rate of complications after glaucoma surgery in highly myopic eyes should be taken into account.

What this means if you are very nearsighted

• Have regular comprehensive eye exams that include an eye pressure check and an optic nerve evaluation, even if your glasses or contacts work well.
• Tell your eye doctor about any family history of glaucoma.
• Ask whether your baseline optic nerve scans and visual fields are on file, so future changes can be compared with your own starting point.
• If you are started on drops “to be safe,” use them as directed and keep your follow-up visits.
• Report sudden flashes, a shower of floaters, or a curtain over your vision right away.

For more plain-language reading on eye health, see foreverfreecontacts.com.

Source: Management of glaucoma in high myopia: Guidelines from the French Glaucoma Society (SFG) and the French-speaking Retina Specialists’ Club (CFSR) (Journal Français d’Ophtalmologie (PubMed), epub 08/26/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.