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Ask Dr. A.S. Desai Your Own Question
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2437
Experience:  MS Ophthalmology with 13 years of surgical expereince
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My brother has one eye drooping of upper eye lid,but when he

Resolved Question:

my brother has one eye drooping of upper eye lid,but when he sing a karaoke to watch tv sceen words his two eyes open as normal.please give me advise and reasons
Submitted: 7 years ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 7 years ago.

How old is your brother?

Does the drooping of the eye disappear every time he opens his mouth such as in singing or while eating? Is there a direct co-relation to his opening of the mouth and correction of the drooping eyelid?

Has the eye doctor evaluated all causes of drooping lids?

Customer: replied 7 years ago.

Hi Dr Desai

my brother is 68 years old, the drooping of the upper eye lid at his one left eye open normaly as usual, everytime when he is in singing Karaoke,but in house his one upper eye lid drooping all the time.

eye doctor examine his both eyes and did the brain-head scanning evaluated all causes of drooping upper eyelid, the report said all fine, but recommend to my brother to try to use a cosmetic injection Botox to his eye. what do you suggestion and comments for the treatment.

thaks for your help.

best regards;

joseph lim.

Expert:  Dr. A.S. Desai replied 7 years ago.
Hello Joseph Lim,

As most of the tests done by the eye doctor were normal , the diagnosis of Ptosis( drooping of the eyelid is called Ptosis) has to be ascertained. The causes of ptosis at this age are involutional ptosis and aponeurotic ptosis and both these conditions are corrected by surgery.

Botulinum toxin injections are usually given in a condition called essential blepharospasm. In this condition usually there is closure of the lids or spasms of the lids especially in response to bright light/stress/driving/reading. It may get alleviated by talking/walking or relaxation.

Botulinum injection is given in low doses at multiple sites around the eye which gives relief from essential blepharospasm. The side effects of this are lagophthalmos, eversion or inversion of the lids , ptosis or diplopia.

I would suggest you first ascertain the exact diagnosis from either the same ophthalmologist or take a second poinion before you go ahead with the botulinum injections . As far as I know botulinum is not the treatment of choice for senile involutional ptosis and is given only in severe essential blepharospasm.

Thanks and best wishes

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