• First Prescription Fix for Droopy Eyelid

    Written By: Reena Mukamal
    Sep. 17, 2020

    An eyedrop called Upneeq is the first drug approved by the United States Food and Drug Administration to treat acquired ptosis, a condition where the upper eyelid droops over the eye. An estimated 11.5% of adults have droopy eyelid, but many don’t know it’s considered a disorder — or that it can be treated.

    Droopy eyelid occurs when muscles that keep the eye open lose function with age. It can affect one or both eyes. As the eyelid droops, the opening of the eye constricts and vision can become impaired.

    “This an exciting development for people suffering from acquired droopy eyelid, who have had limited treatment options. The standard of care for this condition has been surgery. But not everyone is a candidate for surgery. Off-label use of other eye medications is only safe for short-term treatment,” said Kendra DeAngelis, MD, an ophthalmic plastic and reconstructive surgeon and an Academy spokesperson. “Now, we may have a non-invasive, possibly long-term treatment choice to offer our patients.”

    Fixing droopy eyelids without surgery

    The prescription eyedrop provides an alternative to surgery and off-label drugs, the only options for fixing droopy eyelid until now. Upneeq works on a muscle that elevates the eyelid. It causes that muscle to contract, allowing the eyelid to open 1-2 millimeters wider than before treatment.

    Upneeq, which contains the same active ingredient (oxymetazoline) as the nasal spray Afrin, must be reapplied once a day to maintain the effect. But unlike Afrin, which is not safe for long-term use, Upneeq can be used indefinitely.

    According to Osmotica Pharmaceuticals, the company that develops Upneeq, the drug is estimated to cost between $90 and $120 for a 30-day supply. Discounts up to 35% may be available for people who purchase a three-month supply.

    Droopy eyelid treatment may benefit some patients more than others

    Upneeq can help improve mild and moderate droopy eyelid in adults who have acquired or age-related ptosis. It may also help individuals who are experiencing eyelid droop as a side effect of cosmetic botox treatment.

    It will not work for people who have droopy eyelid due to excess skin, saggy eyebrows, or underlying eye injury or nerve problems. The drug is not a treatment for congenital ptosis and has not been studied in children.

    Certain patients, including those with cardiovascular disease or high blood pressure, should consult their primary care doctor before taking this drug. Individuals who are pregnant or breast-feeding should also check with their doctor.

    Mild side effects — including dry eye, eye irritation or rednessblurred vision and headache — occurred in very few (about 1% to 5% of) patients who participated in the clinical trials for Upneeq.

    Ask your ophthalmologist to weigh in on whether your droopy eyelid may benefit from a prescription treatment.