Eyelid Surgery
Lids are a vital component to the ocular system, providing protection from the elements and maintaining an even tear film to allow clear vision. In addition, many people choose lid surgery to improve the way they look—concluding that droopy eyelids, for example, make one look older (as well as impairing vision). Common eyelid problems include excess lid tissue, outwardly turned eyelids and inwardly turned lids. Correspondingly, the most common procedures performed to correct these conditions are blepharoplasty, ectropion and entropion.
Blepharoplasty
Blepharoplasty can be both a functional or cosmetic surgical procedure intended to reshape the upper eyelid by the removal and/or repositioning of excess tissue as well as by reinforcement of surrounding muscles and tendons. When there is excess upper eyelid skin, the skin may hang over the eyelashes and cause a loss of peripheral vision. The outer and upper parts of the visual field are most commonly affected, lids may feel “heavy” or tired, and the condition may cause difficulty with activities such as driving or reading. In this instance, upper eyelid blepharoplasty is performed to improve symptoms. Patients with a lesser degree of excess skin may have a similar procedure performed for cosmetic reasons.
Blepharoplasty is performed through external incisions made along the natural skin lines of the eyelids, such as the creases of the upper lids and below the lashes of the lower lids, or from the inside surface of the lower eyelid. Depending upon the scope of the procedure, the operation takes under one hour to complete. The surgery is done on an outpatient basis and requires only local anesthestic agents. Typically only a few stitches are required and these are removed 7 to 10 days later. Most patients have little if any discomfort with the procedure. Initial swelling and bruising usually resolve within one week, however, final results will not become stable for at least several months after the procedure.
Ectropion
An ectropion is an outwardly turned (everted) eyelid. The condition most often is associated with aging, though it may also occur congenitally, as a result of scarring or other surgeries, or secondary to facial nerve paralysis. If not repaired, the condition may lead to thickening of the mucosal surface on the inside of the eyelid with consequent inflammation of and danger to the health of the eye itself. Most symptoms are due to increased exposure of the eye, resulting in redness and irritation. Ectropion repair is a very routine procedure performed on an outpatient basis. Typically the procedure resolves all symptoms.
Entropion
An entropion is an inwardly turned (inverted) eyelid. The condition occurs primarily as a result of advancing age with consequent weakening of certain eyelid muscles. The imbalance between eyelid muscle groups results in the inward turning of the eyelid. The condition almost always affects the lower, rather than the upper, eyelids.
The main symptom patient experience is foreign body sensation as lashes rub against the eye. Repair of the inversion maybe be completed with a variety of procedures which tighten the lid tissues, resolving the imbalance between the muscle groups of the lower lid. Most patients experience immediate resolution of the problem once the surgery is completed with little if any post-operative discomfort.
