New Eyedrops Can Treat Droopy Eyelids (Ptosis)

by Mar 13, 2022

Another new eyedrop sweeping the nation is the “eye lift drop” better known as Upneeq.

Upneeq is a prescription strength eye drop used to lift the eyelids higher, giving a person the appearance of being more awake or “brighter eyed”.

More specifically, Upneeq is targeted towards helping to improve a condition called acquired ptosis.


What is an Acquired Ptosis?

Acquired means “with age” and ptosis refers to the condition in which the eyelids become a little more droopy, or sit a little lower on the eye than they might have in the past.

Acquired ptosis is thought to affect roughly 11% of the adult population. It is more prevalent in those who have undergone a surgery in the eye/forehead region (such as glaucoma surgery, strabismus surgery, or eyelid surgery) and in long-term contact lens wearers.

This drop is not meant to improve ptosis secondary to neurological diseases such as post-stroke, myasthenia gravis, or Horner’s syndrome.

Upneeq, by RVL pharmaceuticals, received its FDA approval in July of 2020. It is the only FDA approved eyedrop for improving low-lying eyelids secondary to acquired ptosis.

Upneeq consists of 0.1% oxymetazoline hydrochloride solution, a drug that has been previously used in some nasal sprays to help relieve congestion.

This drug is an alpha adrenergic agonist that improves the appearance of low riding eyelids throughstimulation of a muscle called Muller’s muscle to lift eyelids an additional 2-3 millimeters.

This is not to be confused with the main muscle of the eyelid, the levator muscle. The levator muscle is a voluntary muscle (meaning you can control it consciously) that opens the eye 10-12 millimeters.

The muller muscle, on the other hand, is a secondary muscle that helps the levator muscle to open the eye an additional 2-3 millimeters, but works via a different process, making it an involuntary muscle (i.e. we cannot consciously control it).


What are the Limitations of Upneeq?

In other words, Upneeq can help to improve the appearance of a small ptosis, but will not be able to correct a large ptosis. It therefore will be more beneficial in some individuals more so than others, depending on the underlying cause of his/her ptosis.

Upneeq is approved for once a day usage. It is an eyedrop that is instilled into one, or both eyes, typically each morning. An individual will begin to notice its lifting affects after around 15 minutes, although peak benefit has been noted around 2 hours post-instillation.

The affects of Upneeq last all day, there is no need, and it is not recommended, to instill this drop more than once a day.

Since Upneeq is an alpha adrenergic agonist, it does have side effects that can affect other parts of the body.

Alpha adrenergic agonists are known to be vasoconstrictors, meaning they make blood vessels more narrow. In the eye, this can temporarily reduce redness, giving the eyes a “brighter” look. However, it also increases the risk of rebound redness, making the eyes appear redder with more frequent use.


Additionally, vasoconstrictors can increase blood pressure in some individuals, and therefore needs to be used in caution with those with heart problems or on other prescription blood pressure medications.

Other less frequently noted side effects include symptoms of dry eye, headaches, and blurred vision.

At this time, Upneeq is a prescription only medication, and is not currently covered by medical or vision insurance plans. The current cost for a one month supply is roughly $100.00.

If you or someone you know is interested in Upneeq, be sure to make an appointment with your eye doctor today! Understanding the cause behind your ptosis and your unique situation will help to determine if Upneeq would be a good solution for you.


Our eye doctors at Neal Eye Group in Conshohocken, PA excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrists at (610) 828-9701 or schedule an appointment online if you have ptosis and want to discuss if a prescription for Upneeq is right for you.  Our optometrists provide the highest quality optometry services and eye exams in Conshohocken, Norristown, Plymouth Meeting, Lafayette Hill, and Philadelphia.

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