Eye Drops That Lift Your Eyelids: How Oxymetazoline Works

As we age, it’s common for the upper eyelids to begin drooping — sometimes making eyes look tired or even limiting vision. This condition, called acquired blepharoptosis, happens when the muscles responsible for lifting the eyelids weaken or stretch over time [2]. For those looking for a non-surgical treatment option, Upneeq® (oxymetazoline hydrochloride ophthalmic solution), 0.1%, a once-daily prescription eye drop for adults, offers a way to lift the eyelids temporarily and restore a more open appearance to the eye.

What Are Upneeq Eye Drops?

Upneeq eye drops are a prescription treatment designed to lift droopy eyelids caused by acquired ptosis. Oxymetazoline is the active ingredient in Upneeq, an ophthalmic solution containing oxymetazoline hydrochloride 0.1%. Upneeq is the first and only FDA-approved eye drop for this condition in adults. [2]

How Do Eye Drops Lift Droopy Eyelids?

Prescription oxymetazoline-containing eye drops, like Upneeq, lift droopy eyelids by stimulating the small muscle inside the upper eyelid that helps raise it. Your upper eyelid is lifted by two main muscles. One of them is called Müller's muscle, a small muscle controlled by the sympathetic nervous system [7]. When this muscle contracts, it slightly raises the eyelid.

Oxymetazoline activates receptors in Müller's muscle, causing it to contract and lift the upper eyelid [1]. This action temporarily improves the appearance of low-lying eyelids and may help open up the visual field [3]

Clinical Results: What Studies Show

In clinical studies, patients showed an improvement in their upper field of vision compared to those in the vehicle group [1]. Upneeq also produced a measurable lift in the upper eyelid, known as the marginal reflex distance, or MRD-1, after a single dose [1]. Some patients saw results as fast as five minutes, with the highest lift generally occurring two hours after dosing and continuing for up to eight hours after each use [3]. The average upper eyelid lift with Upneeq in clinical studies was 1 mm.

How Prescription Eye Drops Compare to Other Options

Acquired ptosis can be managed in several ways. Treatment options range from surgical to non-surgical methods.

• Surgical procedures are available, such as levator muscle advancement [7]. These procedures offer a permanent correction [6]. 
• Prescription oxymetazoline eye drops offer a unique, non-surgical alternative [6]. They are a pharmaceutical solution that provides a temporary, daily lift [6]. Unlike surgery, the effects last only as long as the medication is active [1]. 

Upneeq eye drops represent a significant advancement in non-surgical options for acquired ptosis. Because the drops work through daily use, knowing how to use them is important.

How to Use Upneeq Eye Drops

Read this Instructions for Use before you start using Upneeq. These instructions do not take the place of talking to your healthcare provider about your medical condition or your treatment.

Upneeq is packaged in a single patient-use, child-resistant foil pouch. Do not remove the vial from the foil pouch until you are ready to use Upneeq. Wash your hands before each use to make sure you do not infect your eyes while using Upneeq. If you are using Upneeq with other eye (ophthalmic) medicines, you should wait at least 15 minutes between using Upneeq and the other medicines. If you wear contact lenses, remove them before using Upneeq. You should wait at least 15 minutes before placing them back into your eyes.

  

Step 1: Cut open foil wrapper and remove single-use vial.

Step 2: Apply one drop to each affected eye as directed, once a day or on days when your eyelids need a lift.

• Tilt head back and apply one drop in each affected eye.
• Do not let the tip of the vial touch your eye or any other surface to avoid contamination or injury to the eye..
• Upneeq vials are single-use only and should not be reused after opening.
• After applying the drops, immediately discard the vial in the trash. Do not save any unused Upneeq.

You may see a lift within 5-15 minutes, with results lasting up to eight hours for most patients [2]. Always use the drops as directed and store them properly to maintain effectiveness. 

Warning and Precautions Associated with Upneeq

It's important to be aware that Upneeq may not be suitable for everyone. Here's a breakdown of specific conditions and considerations:

• Low-lying lids may be related to conditions such as stroke and/or brain aneurysm, Horner syndrome, myasthenia gravis, loss of the ability to move eye muscles, eye infection and eye tumors. Tell your doctor if you have any of these conditions.
• Upneeq is a type of medication that may affect your blood pressure. If you have heart disease, uncontrolled high or low blood pressure, or feel faint at rest or when quickly standing up, you should call your doctor if your symptoms get worse.
• Patients with reduced blood flow to the brain or heart, or patients who experience eye or mouth dryness due to an immune system disorder (Sjögren’s syndrome), should use care when taking Upneeq. Call your doctor immediately if you feel your symptoms may be getting worse.
• Upneeq may increase the risk of eye pressure due to fluid buildup (angle-closure glaucoma) in patients with untreated narrow-angle glaucoma. Call your doctor immediately if you feel increased pressure in your eye after using Upneeq.
• Do not let the tip of the Upneeq vial touch your eye or any other surface. This can help prevent eye injury or contamination. Each Upneeq vial is for one-time use and should be discarded after being used.

If you have droopy eyelids caused by acquired ptosis, ask your healthcare professional if Upneeq is right for you.

Related Resources:

• How Long Does Upneeq Last?
• Diagnosing Ptosis: What to expect when you visit your doctor
• Understanding & Preventing Droopy Eyelids

Sources:

1. Upneeq Prescribing Information PDF
2. Upneeq Patient Brochure PDF
3. Upneeq FAQs PDF
4. Farber SE, Codner MA. Evaluation and management of acquired ptosis. Plast Aesthet Res. 2020;7:20. 
5. Shahzad B, Siccardi MA. Ptosis(Archived) [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan.
6. Bacharach, J., Lee, W.W., Harrison, A.R. et al. A review of acquired blepharoptosis: prevalence, diagnosis, and current treatment options. Eye 35, 2468–2481 (2021). 
7. Sudhakar P, Vu Q, Kosoko-Lasaki O, Palmer M. Upper eyelid ptosis revisited. Am J Clin Med. 2009;6:5-14.