Upneeq Review: Can Eyedrops Really Open The Eyes?

Upneeq Review: Can Eyedrops Really Open The Eyes?

| |
| |

Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to prescription medication.

Upneeq is a prescription medication eyedrop used to treat ptosis, which is a medical term for drooping of the eyelids. According to the brand's website, Upneeq is the only medication approved by the Food and Drug Administration (FDA) for this condition.

The generic name for Upneeq is oxymetazoline hydrochloride ophthalmic solution 0.1%. These two terms refer to the same active drug ingredient, so we will use them interchangeably throughout this article.

But can eyedrops really open the eyes and improve vision and appearance? Is Upneeq proven to work in clinical studies? Does it cause side effects? And how do real Upneeq users rate and describe the effects of this treatment?

In this article we’ll answer all of these questions and more, as we review clinical studies on Upneeq to determine if it’s a safe and effective treatment for drooping eyelids.

We’ll discuss potential side effects, feature unsponsored patient reviews and compare Upneeq to a surgery used to correct drooping eyelids.

Does Upneeq Work?

Ptosis, short for blepharoptosis, can affect both the aesthetic appearance and function of the eyes. According to the American Academy of Ophthalmology, this condition can limit or block vision. 

For a ptosis medication like Upneeq to work, it needs to help patients open the affected eye(s) so that their vision improves. U sed unilaterally their face may become more symmetrical. (which improves aesthetic appearance).

A medical review published in the JAMA Ophthalmology journal examined the effects of Upneeq on vision.

The study authors found that patients using Upneeq experienced a significant improvement in vision.

The number of points on a visual scale that the trial participants could see more than doubled when using Upneeq when compared to placebo treatment, from 1.8 points to 5.9 points on average.

However, it's worth noting that the above-linked medical review was sponsored by the manufacturer of Upneeq, which may create bias.

A 2021 clinical trial examined the effects of Upneeq on eyelid drooping.

304 patients with acquired blepharoptosis were evaluated in total. The eyelid elevation in the Upneeq patient group was superior to that in the placebo group to a statistically significant degree. 

15 minutes post-treatment on day 1 of the trial, eyelids raised 0.93 millimeters (mm) in the Upneeq group versus 0.32 mm in the placebo group. 15 minutes post-treatment on day 14 of the trial, eyelids raised 1.11 mm in the Upneeq group and only 0.41 mm in the placebo group.

These results show that Upneeq improved eyelid drooping by over 100% compared to placebo.

We can conclude from the available research that Upneeq is likely to be effective for both improving vision and making the eye appear wider in patients with eyelid drooping.

Here is the link to Upneeq's official distributor, for patients interested in this medication.

Real People Try Upneeq

A YouTube creator and board-certified opthamologist named Dr. Rupa Wong tried Upneeq and shared her experience:

A YouTube creator named Jessica deBen has a review of Upneeq that's only around one minute long, and focuses more on the aesthetic effects of the medication:

Does Upneeq Cause Side Effects?

The safety of Upneeq has been extensively tested in clinical trials.

A 2021 medical review analyzed the safety of Upneeq based on results from four clinical trials.

The total adverse event ratio was 31.2% in patients using Upneeq and 30.6% in patients using placebo. This means that only 0.6% more patients reported side effects on Upneeq than on placebo. 

This is a relatively low “true” side effect ratio compared to most medications we’ve reviewed to date on Illuminate Health.

The most common side effects of Upneeq were punctate keratitis (a disorder that causes eyes to become irritated and sensitive to light), excess of blood vessels in the eye, dry eyes and blurry vision.

None of these side effects were experienced by more than 3.5% of the study population, and 98% of patients across all trials reported no or “mild” side effects.

Before-and-After Images

Because ptosis can cause facial asymmetry, many patients are as interested if not more interested about the potential aesthetic benefit of Upneeq compared to the vision benefit.

Upneeq provides before-and-after images of real patients who used their medication, which can be seen below:

Upneeq before-and-after images

How Much Does Upneeq Cost?

Upneeq is relatively expensive without health insurance.

GoodRx reports that the average retail price is around $220 at the time of updating this article.

Upneeq’s website details that their medication is also available for purchase directly from medical providers.

We recommend that patients speak with both their doctor and their health insurer prior to purchasing Upneeq, to see if they can access a reduced price for the medication.

An official retailer of Upneeq called Skin Solutions is currently retailing a 30-pack of Upneeq for $150.

How Does Upneeq Work?

The active chemical compound in Upneeq was initially prescribed as a nasal decongestant, and its use for treating ptosis is a recent development.

Researchers aren’t entirely sure of the mechanism of action of Upneeq, but there are some theories in the medical literature.

The first-linked medical review that we cited in this article includes a statement where the study authors hypothesize that Upneeq may cause contraction of a muscle that is weakened or dysfunctional in patients with ptosis. Once this muscle is contracted, the eyelid is lifted like a lever:

“It is hypothesized that oxymetazoline, 0.1%, stimulates α-adrenergic receptors on Müller muscle.”

Upneeq appears to work due to a nervous system response to the medication, because the weakened muscle which causes ptosis does not come in direct contact with the eyedrops.

Is Upneeq Better Than Surgery?

One of the most common treatments for ptosis is corrective surgery which repositions the eyelid.

This surgery may treat the root cause of the disorder, but it also carries a risk of complications. A medical review on blepharoptosis treatment called this surgery “perhaps the most challenging in the field of oculoplastics.”

This surgery carries risks such as orbital hemorrhage, where bleeding in the eye can cause permanent vision loss. There’s also around a 10% risk that the surgery is done improperly and a second corrective surgery is required.

Upneeq is a first-line treatment for ptosis that's worth discussing with a doctor in our opinion, given its low risk and relatively mild side effect profile.

It’s also significantly less expensive than surgery, and less invasive.

Patients Review Upneeq

Drugs.com is a website that allows prescription medication patients to rate and review the drugs they're taking.

We cannot verify the accuracy or authenticity of any reviews on this site.

At the time of updating this article, Upneeq has been reviewed 11 times on Drugs.com, and has an average review rating of 8 out of 10.

A positive review comes from a user named “Kima” who gives the drug a 9/10 rating, and who was impressed with the aesthetic benefit that the medication provided:

“I like the 'opened-eye' look one drop a day gives me. Didn’t realize how sleepy I looked before my Opthomologist recommended for one eyelid that was drooping a bit. We discovered I needed one drop in each eye, otherwise my eyes looked uneven.”

A negative review is written by a user named "Carol..." who claims to have experienced side effects:

"My eyes burned so badly I took out my contacts immediately upon returning home. The burning didn’t stop. Woke up the next morning with a bright red eye hemorrhage."

Stay up-to-date on our research reviews


Upneeq is clinically shown to be effective for treating both the vision problems and aesthetic issues that come with ptosis.

This medication has one of the mildest side effect profiles for a prescription drug that we’ve reviewed in an Illuminate Health article.

We believe that Upneeq is worth discussing with an  ophthalmologist before considering corrective surgery, given its relatively favorable risk profile.

The small sample size of user reviews of Upneeq on Drugs.com are highly positive in the aggregate.

Upneeq is relatively expensive without health insurance in the US, so it's worth speaking with a doctor and health insurer about strategies to access this medication at a subsidized cost.