Open Your Eyes: New Upneeq Eye Drops to Lift Eyelids By Dr. Sutton Graham on April 24, 2022

Do your eyes look tired?  Were your eyes brighter when you were younger?  Do your upper lids droop down a little?  Did you know that there may be a simple solution: eye drops?  Upneeq is a new prescription eyedrop that lifts your upper eyelids to open your eyes.   This photo of our office manager shows the effect on her left eye, the right one in the photo.

A little background information is in order.  Dr. Graham frequently performs upper blepharoplasty to remove redundant lax skin of the upper eyelid.  That excess skin makes your eyes look full, tired, droopy or puffy.  The surgery is one of the simpliest in cosmetic surgery and is often performed under local anesthesia as a brief office procedure.  This condition is termed dermatochalasis, and is very common.

A less common conditon is called acquired blepharoptosis, in which the eyelid edge covers too much of the pupil, effecting vision.  These patients have a partially obscured upper field of vision (visual field defect).  This is caused by gradual stretching or relaxation of the tiny ligaments and muscles within the upper eyelid lifting mechanism.  If the symptoms are significant surgery is done to correct the cause.  This is perfromed by specialiized ophthalmologists, and is different from cosmetic blepharoplasty.  It is covered by most health insurance plans.

Upneeq is a eyedrop that lifts your upper eyelids to open your eyes.  Oxymetazoline hydrochloride ophthalmic solution is the only FDA approved prescription eyedrop for acquired ptosis (low-lying lids).  Upneeq is available from our office.  As with all medications there are potential  side effects and risks.  The company website link is

The official caution paragraphs are included below:

UPNEEQ® (oxymetazoline hydrochloride ophthalmic solution), 0.1% is a prescription eyedrop used to treat acquired blepharoptosis (low-lying lids) in adults.

What warnings and precautions are associated with UPNEEQ?

  • 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.

What are the most common side effects of UPNEEQ?

The most common adverse reactions with UPNEEQ (occurring in 1-5% of patients) were eye inflammation, eye redness, dry eye, blurred vision, eye pain at time of use, eye irritation, and headache.

What should my doctor know about before prescribing me UPNEEQ?

  • Your doctor should review your full medical history before prescribing UPNEEQ.
  • UPNEEQ belongs to a class of medication (alpha-adrenergic agonists) that may affect your blood pressure. Use UPNEEQ carefully if you currently take an alpha-adrenergic agonist medication to treat heart disease or an enlarged prostate. Patients taking beta-blockers, or other medications to treat hypertension or an abnormal heartbeat, should also be careful when using UPNEEQ.
  • Patients who use a certain class of antidepressant medication (monoamine oxidase inhibitors) should also be careful when using UPNEEQ, as it may affect the way your body absorbs the medication.

These are not all of the possible side effects of UPNEEQ. Tell your doctor if you have any side effect that bothers you or does not go away. Call your doctor for medical advice about side effects.

To report side effects or product complaints, contact RVL Pharmaceuticals at 1-877-482-3788. You may also report side effects to the FDA by calling 1-800-FDA-1088 or visit

This is a summary of the most important safety information for UPNEEQ. For more in-depth safety information, please review the full Prescribing Information for UPNEEQ.

Dr. Sutton Graham

Aesthetic Center Greenville

Dr. Graham has been performing plastic surgery since 1990. He is dedicated to providing high-quality, personalized treatment, and is affiliated with several prestigious organizations, including:
  • American Board of Plastic Surgery
  • American College of Surgeons
  • American Society for Aesthetic Plastic Surgery
  • American Society of Plastic Surgeons

To learn more, contact us online or call our Greenville, SC, office at (864) 676-1707​.

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"I am very pleased with Dr. Graham and his staff! They have been incredibly kind and helpful throughout my surgery. The post-op care has also been top notch! They always respond to my concerns right away, and I always feel well cared for, and listened to." Mary V.

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