Blepharoptosis can impair daily activities due to obstruction of the visual axis. Although it is often caused by involutional chages, it may also be the presenting sign of underlying systemic disease.
A 50-year-old woman presented to her GP complaining of droopy upper eyelids that had been slowly worsening over several years (Figure 1). Her superior visual field was obstructed, but she could resolve this by lifting the lids manually. The eyelid droop remained constant throughout the day and she denied any pain, swelling, redness or lumps. She had no history of trauma, prior eye surgery or muscle weakness elsewhere in the face or body.