Recent Advances in the Diagnosis and Management of Ptosis: A Systematic Review of Surgical and Non-surgical Interventions

Author(s): Niraj Kumar Yadav, Ajay Kumar Arya, Priyanshi Priya, Sadaf Abbasi, Shweta Sajimon, Eesha Agarwal

Ptosis, the abnormal drooping of the upper eyelid, is a condition with both functional and cosmetic consequences that can significantly impair vision and quality of life. Recent years have witnessed notable advances in its diagnosis and treatment, reflecting a shift toward more personalized, less invasive, and technologically driven approaches. This systematic review synthesizes the latest developments in ptosis management from 2018 to 2025, including surgical refinements, nonsurgical pharmacologic therapies, device-based aids, and artificial intelligenceassisted diagnostic tools. Traditional surgical techniques such as levator resection, frontalis sling, and Müller’s muscle-conjunctival resection continue to demonstrate high efficacy, with evolving modifications improving complication profiles and recovery times. Non-surgical interventions, particularly the use of oxymetazoline 0.1%, offer effective eyelid elevation in patients with mild-to-moderate acquired ptosis, providing a valuable alternative for non-surgical candidates. Innovations in diagnostics, including AI-powered image analysis, smartphone-based assessment tools, and biomechanical eyelid modeling, are enhancing early detection, surgical planning, and postoperative monitoring. Additionally, experimental approaches involving smart biomaterials, such as magneto-responsive implants and genetic profiling, are emerging with promising applications in neurogenic and congenital ptosis. Despite these advancements, gaps remain in standardizing outcome measures and validating newer technologies in large, diverse patient populations. The field is clearly moving toward an integrated, precision medicine model, where treatment decisions are guided by both anatomical and technological insights. Continued interdisciplinary research will be essential to translate these innovations into scalable clinical practice and optimize outcomes for individuals affected by ptosis