Living in this new masked world, our eyes are the way we communicate, through both expression, and the occasional smoky eye of course. But for many of us—men and women—droopy eyelids make us look tired, which usually isn’t the way we feel on the inside. It’s called ptosis, and it’s an issue that affects millions of people in the U.S. alone: Google searches for “drooping eyelid surgery” have increased 400 percent in the last month. Searches for “eyelid lift without surgery” are also trending, which is why a new eye drop called Upneeq is generating quite the buzz among both consumers and medical communities alike.
Approved by the FDA in July 2020, the new eye drop works on cases of acquired ptosis, which is when the muscle that lifts the eyelid starts to lose some of its strength over time, causing the lids to droop. “It’s called ‘acquired’ because we acquire it as we age,” says Beverly Hills, CA oculoplastic surgeon Raymond Douglas, MD. “This can often occur for contact-lens wearers or those who have had cataract surgery, or just as a result of general aging—it happens to adults of all ages. The drooping can be subtle at first, but all of sudden you look in the mirror one day and it’s more dramatic.” However, it’s best not to self-diagnose with Dr. Google, as so many of us tend to do: “The drooping can be related to an underlying medical condition in some cases, so it’s important to see a doctor.”
The eye drop contains 0.1 percent of an active ingredient called oxymetazoline hydrochloride, which activates the receptors in the muscle responsible for lifting the eyelid and contracts the muscle for up to eight hours. “Previously, we only had surgery as an option, in which we shorten the muscle,” says Miami oculoplastic surgeon Wendy W. Lee, MD. “If a patient comes in with mild ptosis, like 1 millimeter of droopiness, most times I won’t operate and they just have to live with it unfortunately. But now, Upneeq is an amazing and exciting option for these patients. They notice their field of vision increases with just a drop—more light comes in and there’s less shading.”
One drop is recommended in each eye in the morning—or just one eye, if ptosis only affects one—and can work in as little as five minutes, but can take up to two hours in some patients. “In clinical trials, the average eyelid position was lifted by 1 millimeter, which is quite significant because the eyelid often only opens about 3 millimeters or so,” says Dr. Douglas. “The results also revealed 88 percent of patients saw improvement.”
For more moderate-to-severe cases of ptosis, Dr. Lee recommends ptosis surgery, which shortens or advances the muscle to open the eyelid more. “We’re changing the position of the eyelid, which is different than upper blepharoplasty, which removes excess skin from the upper eyelid.”
Upneeq is available via prescription and can also be used by those who wear contacts or have had laser eye surgery. “There have been no specific contraindications for using this with other eye drops as well, and overall it’s well-tolerated by all users,” says Dr. Douglas. “Side effects include minimal redness or dryness, and only impact 1 to 5 percent of users.”
Kirbie Johnson, beauty expert and cohost of the Gloss Angeles podcast, is eager to spread the word about the new eye drop because she has a personal tie to it. “I was born with congenital ptosis, so I looked sleepy all the time. When I was little, I was constantly tilting my head back to look up and see my mom,” she recalls. “My eyelids were covering a significant portion of my iris and impairing my vision. Then I had ptosis remedy surgery when I was three, and it was not only lid-altering, but also life-altering. I could see the world better.”
Last year, Johnson noticed her left eyelid was becoming heavier, which she chalked up to getting older, but she turned to the internet to find information on “ptosis surgery follow-up” and ended up scheduling an appointment with Dr. Douglas to learn more. “I’m on camera a lot, so I’m constantly noticing my eyes, and I noticed I was tilting my head to make my left eyelid look balanced,” she says. “Dr. Douglas let me know that I didn’t need another surgery just yet and mentioned that my left eye was a little bit heavier due to acquired ptosis. That’s when I tried Upneeq. It’s truly remarkable how well I can see out of my left eye now. I look more aware and feel more awake, and my peripheral vision is so much better.”
