The inability to open the eyelid fully is called ptosis. It can occur in one or both eyelids. It can be partial or complete. It can be congenital or acquired due to ageing or nerve injuries. For the congenital ptosis it is due to partial or complete weakness of the Levator muscles pulling up the eyelids. If partial a tightening of the affected muscle will give encouraging results. In complete absence or weakness of the muscles a more complex operation is required where a tendon is used to attach the eyelid to the forehead muscle so that this will lift up the weak eyelid. We can use the patient's own tendon (preferred) or from other other sources. In the older patient this is often due to the progressive weakness of the Levator muscle combined with the dropping forehead skin. This is called Blepharoptosis and the operation is to tighten the muscle and remove the excess upper eyelid skin so that the muscle pull can be strengthened. If left uncorrected patient may have difficulties in vision and also irritations of the eye as the eyelashes will irritate the affected eye.