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For complete eye health, your eyelids need to be as healthy as your eyes.
Eyelid position is also important to your appearance. Excess eyelid
skin, droopy eyelids or eyelids that turn inward or outward are common
problems. They can cause eye discomfort, and even limit vision.
Fortunately, such eyelid conditions are correctable by surgery.
Ptosis: Upper eyelid
drooping
Ptosis ("toe-sis") is apparent at birth (congenital) or develops with age
(involutional) .
Ptosis is a condition where the upper eyelid droops over the eye.
After surgery, the upper eyelid is restored to its normal position.
A child with congenital ptosis
may tilt his or her head backward in order to see, so it does not always
lead to poor vision. However, children with ptosis should be examined
by an ophthalmologist because they can have other associated eye problems.
Surgery to correct ptosis is commonly recommended in the preschool years to
make it easier for children to see and to improve appearance. The type
of surgery varies, depending upon how much the eyelids droop.
Involutional ptosis develops with aging. It may worsen after other
types of eye surgery or eyelid swelling. Ptosis may limit the field of
peripheral vision and produce an uneven appearance. Surgery corrects
the problem by shortening the muscle that opens the eyelid.
Excess eyelid skin
Over time, many people develop excess
eyelid skin. Eyelid skin is the thinnest skin of the body, so it tends to
stretch. In the upper eyelid, this stretched skin may limit the
peripheral field of vision, and may produce a feeling of heaviness and a
tired appearance. In the lower eyelid, "bags" form. The excess
skin in the upper eyelids can be removed surgically by a procedure called a
blepharoplasty to improve the peripheral field of vision and other symptoms.
Removal of the excess skin in either the upper or lower eyelids may improve
appearance. If excess fatty tissue is present, it may be removed at the same
time.
Excess eyelid skin may produce a heavy sensation as well as
limit the field of peripheral vision.
Ectropion: Outward turning of the lower
eyelid
Stretching of the lower eyelid with age
allows the eyelid to droop downward and turn outward. Eyelid burns or
skin disease may also cause this problem. Ectropion can cause dryness
of the eyes, excessive tearing, redness and sensitivity to light and wind.
Surgery may restore the normal position of the eyelid, improving these
symptoms.
Entropion: Inward turning of the lower
eyelid
Entropion also occurs most commonly as a
result of aging. Infection and scarring inside the eyelid are other
causes of entropion. When the eyelid turns inward, the eyelashes and skin
rub against the eye, making it red, irritated and sensitive to light and
wind.
In these drawings, the eyelid is cut away to
show the appearance of the normal eyelid (left), and the eyelid turning
outward (center) and inward (right).
If entropion is not treated,
an infection with an ulcer may develop on the clean surface of the eye
called the cornea. With surgery, the eyelid can be turned outward to
its normal position, protecting the eye and improving these symptoms.
Eyelid plastic surgery
Eyelid plastic surgery is almost always
performed on an outpatient basis using local anesthesia. Before
surgery, your ophthalmologist (medical eye doctor) will perform an eye
examination and make recommendations. Photographs and visual field
testing are often required by insurance companies before blepharoplasty and
ptosis surgery. If you are planning to have surgery, be sure to tell
your ophthalmologist if you are taking aspirin or aspirin-containing drugs,
blood thinners, or have a bleeding problem. This surgery is generally
safe; however, as with any surgery, there are certain risks:
- The ophthalmic surgeon will
attempt to make both eyes look similar, but differences in healing
between the eyes may cause some unevenness in the appearance following
surgery.
- A "black eye" is common, but will go
away quickly.
- The eye may feel dry after surgery,
because it may be more difficult to close your eyes completely.
This irritation generally disappears as the surgery heals.
- Serious complications are rare.
The risk of losing vision is estimated to be less than one in 5000
surgeries. Infections and excessive scarring occur infrequently.
Eyelid plastic surgery procedures can be
done safely in an outpatient setting by your ophthalmologist. The
improvement in vision, comfort and appearance can be very gratifying.
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