Upneeq Eye Drops reviewed by Seattle Optometrist

Upneeq Eye Drops

This before and after treatment shows the effect of Upneeq drops by RVL Pharmaceuticals

If you notice one (or both) of your eye lids starting to droop, what can be done about it?  Sure, you could get a surgical consult with a ophthalmologist trained in lid surgery and plastic surgery, but for most of us that’s overkill.  Plus, every surgery has risk.  There is a new treatment, Upneeq eye drops that can help significantly.

What Are Upneeq Eye Drops?

Upneeq (oxymetazoline hydrochloride 0.1%) is Rx-only, and is approved for the treatment of “acquired ptosis” in adults.  Ptosis is the medical term for a droopy eyelid.  Ptosis or “blepharptosis” typically occurs from a partial or complete dysfunction of muscles that raise the upper eyelid.  Many optometry and ophthalmology clinics around the country have samples of Upneeq that you may be able to try in office.  We do have samples at our two Seattle locations of Cannon EyeCare.

According to the Upneeq website, it is the only approved prescription medication by FDA for ptosis. While it is becoming a popular drug, it is important for users to know all about it so they can decide whether or not they want to use it.

Does Upneeq Work?

Typically we like to take a quick baseline photo of the patient pre-treatment.  Then we put a drop in the effected eye(s), and about 10 minutes later we take a second photo.  Pretty much every patient we have tried it on has opted to get an Rx for the drug.  Upneeq is generally well tolerated because for most of us there’s no sting and no perceptible side effects for the vast majority of patients.

The drug has been shown to work in as little as 10 minutes, and the lid lift typically lasts about eight to ten hours.  It is meant to be used just once daily and has potential side effects of dry eye, redness and irritation.  Many patients have undiagnosed mild dry eye.  Therefore, Cannon EyeCare only tries the drug on patients who do not have dry eye or whose dry eye is well controlled.

The image below shows an otherwise healthy woman in her 20s with an acquired ptosis on her left eye.  The top image is pre-treatment.  The lower image shows her 10 minutes after drop instillation.  The corresponding 1.5mm lift from treatment restored symmetry to her lids.

Ptosis does not affect the aesthetic appearance of the eyes alone but it also affects the function of the eyes.  As per the American Academy of Ophthalmology, Ptosis can also limit vision or block it completely.

JAMA Ophthalmology published a medical review that examined the uses of Upneeq and if it could improve vision. The results of the medical review showed that patients using Upneeq could significantly improve vision.

Among this and other studies the difference in patients before and after was notable. Patients involved in the review could see doubled, 1.8 points to 5.9 points. Other than that, as per the results of other studies, examiners could see a significant improvement in the eyelid drooping. Therefore, it means that Upneeq is effective in improving the aesthetic appearance as well as the vision.

Furthermore, it is important to note that Upneeq is a fast acting drug that can help you in a matter of minutes which makes it a very convenient option for all those who suffer from drooping eyelids.

How Does This New Drug Work?

The formula for Upneeq has two active chemical compounds. Their exact workings are unknown but there are some theories by different experts.

In our research, Dr. Cannon learned that one of the compounds was previously used as a nasal decongestant but has not previously been approved to treat Ptosis.  Upneeq may cause the contraction of the weak muscle that causes droopy eyelids. With the contraction of this muscle, your eye will lift up automatically. Upneeq stimulates a-adrenergic receptors on the Muller muscle.

Your nervous system responds to the drug and the muscle is not in direct contact with Upneeq.

What Does Upneeq Cost?

If you do not have health insurance then Upneeq can be expensive. You can get more details from the website of Upneeq itself. It is also available for purchase at different medical providers.

What Are The Possible Side Effects Of Upneeq?

There have been several medical trials that study the safety of Upneeq. One of such medical reviews studies four individual clinical trials and the side effect ratio between patients who reported side effects on Upneeq was only 0.6% higher than the ones on placebo.

Such a ratio is great and a low ratio as compared to other medication. One of the most common side effects includes punctate keratitis (focal corneal irritation). In this disorder, eyes are sensitive to light and are suffer from irritation or sensations of dryness. Other than that, you can experience an excess of redness in the white of the eye, blurriness and dryness in your eyes. However, these side effects are rare and only a small percentage (1-5%) of the population is likely experience it.

However, it is essential for patients to first consult with their doctor and discuss their medical history before they can start taking Upneeq.

Is Upneeq An Alternate To Surgery?

The most common treatment for Ptosis is corrective surgery. This surgery repositions the eyelid so that it doesn’t droop anymore. While surgery can treat the actual cause of the problem, there are several associated risks. It can also be very challenging for the doctor to perform the surgery, and as with any surgery, things don’t always go to plan.

The risks of surgery include orbital hemorrhage, which can lead to permanent loss of vision. The chances of patients needing a second corrective surgery are high. In that case, Upneeq is a much safer and effective treatment. It does not have many adverse side effects and is significantly cheaper than surgery.

However, it is best to take help from a medical professional and they will be able to guide you as per your situation.  Your particular case may not be fixed with this eye drop; many cases of ptosis do require surgery.

How To Use Upneeq?

It is easy to use Upneeq, all you have to do is place a drop of the solution in your eye, once a day. The application is very easy and does not cause any pain.

When using the drops, you can lean your head all the way back and open your eyes to look up. Open the applicator and hold it right over your head so you can quickly squeeze the solution your eye. If you have squeezed more than needed then just blink your eye and it will rid of the excess.

You can use Upneeq occasionally or every day.

Pros & Cons Of Upneeq


  • No need for surgery; FDA-approved prescription eyedrop treatment for drooping or sloping eyelids
  • Effects last for up to eight hours at a time and are easy to apply with a simple eye drop once daily.
  • Very effective
  • Short time between first dose and seeing real results


  • Requires daily eye drops, which may be an uncomfortable process for those who dislike drops
  • Requires a prescription, so it’s not just something you can buy at the local pharmacy without a prescription
  • Can be challenging to find in various locations.
  • It’s a recurring cost unless covered by your medical insurance


Upneeq eye drops are an effective solution if you want good results and quick. But if you are looking for a long term solution then it is best for you to first consult your doctor before you do anything else. With its success rate and low side effects ratio, it is a safe alternative to surgery and can give you your desired results in the matter of a couple of minutes.