This slide shows a person with ptosis, a droopy eyelid. This condition can be due to mechanical or neurologic factors; for example, it can occur after eye surgery. However, evaluation of ptosis should include examination of extraocular muscles and pupils. The possibilities of a thirdnerve palsy, Horner’s syndrome, and myasthenia gravis should be considered. If there is any doubt, eyelid problems should be referred to an ophthalmologist for thorough evaluation. With time and age the layers of skin over the eyelids can lose their elasticity and droop, a condition called dermatochalasis. Sagging skin that starts to interfere with the superior visual field can be removed surgically. In general, any patient whose eyelid obscures his or her central pupil should be referred.