Drooping of the eyelid is common in elderly patients and is often considered a normal ageing change. However, when eyelid drooping is associated with pain, it is not normal and should always be evaluated carefully.
A 61-year-old woman presented with mild drooping of the right upper eyelid along with persistent eye pain for two months. She had no diabetes, blood pressure, or thyroid disease.
Age-related ptosis is usually painless. The presence of pain raised suspicion of an underlying orbital or neurological condition rather than a simple eyelid problem.
Clinical examination showed mild ptosis with normal vision and pupils, but pain increased on eye movement. The patient was advised an MRI of the brain and orbit with contrast, which revealed features suggestive of orbital inflammatory disease.
After ruling out infection and tumors, the patient was started on oral corticosteroids. She experienced significant pain relief within 48–72 hours, and the eyelid drooping gradually improved. Steroids were slowly tapered to prevent recurrence.
Key Message
Painful ptosis in elderly patients is a red flag.
Early imaging and timely treatment can completely reverse the condition and protect vision.
If you notice new eyelid drooping with eye pain , consult an eye specialist without delay.
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