When 19-year-old Sabrina Burlando shared her life's journey with Congenital ptosis through Tik Tok, she didn't expect it to get such an overwhelming positive response from strangers. It went viral and People exclusively reported on Burlando’s condition and experiences, highlighting both medical and personal aspects of life with congenital ptosis.
Congenital ptosis refers to drooping of the upper eyelid that is present at birth or within the first year of life. The condition results from underdevelopment or dysfunction of the muscles that normally lift the eyelid, most often the levator palpebrae superioris muscle.
In normal anatomy, coordinated eyelid muscle function allows blinking and full eyelid elevation. In congenital ptosis, the eyelid may droop to varying degrees, sometimes limiting eyelid closure and opening.
Muscle development defects - the most common cause where the levator muscle fails to develop normally.
Genetic inheritance - congenital ptosis can run in families through inherited patterns.
Neurologic or nerve-related issues - nerve supply abnormalities to eyelid muscles can lead to ptosis.
The condition may occur in one or both eyelids and usually becomes noticeable early in infancy.
According to People, Burlando was born with congenital ptosis and was unable to blink naturally due to an absence or extreme weakness of the eyelid-lifting muscle.
At age 3, she underwent surgery designed to improve eyelid function. Rather than restoring typical blink mechanics, the procedure enabled her to blink by engaging alternative muscles, specifically eyebrow muscles, which affects the visual appearance of her eyes.
This surgical approach reflects a common strategy in ptosis management where other muscles are used to compensate for weak levator muscles.
Drooping upper eyelid present since birth.
Compensatory muscle use, such as frontalis (forehead) muscle to raise the eyelid.
In some severe cases, limited or absent blink reflex tied to muscle impairment.
Diagnosis generally involves clinical evaluation by a pediatric ophthalmologist, assessing eyelid position, muscle function, and visual impact.
Untreated ptosis in children may interfere with visual development, potentially causing:
Amblyopia (lazy eye) due to obstructed vision.
Compensatory head positioning as a child tilts their head back to see beneath a drooping lid.
The primary treatment for congenital ptosis is surgery, tailored to the severity of the droop and functional concerns. Techniques include:
Frontalis sling procedures - connecting eyelid to forehead muscle to improve raising ability.
Levator resection or advancement - strengthening the existing eyelid muscle when possible.
Timing of surgery varies, often considered in early childhood if vision is at risk.
References
Shukla, Unnati V., and Bhupendra C. Patel. “Congenital Ptosis.” In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2025. Accessed January 13, 2026. https://www.ncbi.nlm.nih.gov/books/NBK568688/.
American Academy of Ophthalmology. Ptosis — What Is Ptosis? Accessed January 13, 2026. https://www.aao.org/eyehealth/diseases/what-is-ptosis
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