EYELID DISEASE (Functional Oculoplastic Surgery )

INTRODUCTION

Eyelids are an important part of our body. They protect our eyes from foreign objects like dust and sand. Eyelids also help in retaining the moisture of our eyes through the act of blinking. Various diseases and eyelid disorder can cause poor vision, and/or can alter one’s physical appearance. Poor eyelid health also causes irritation and discomfort in the eye. Eyelid diseases are rarely serious, but it is highly recommended to visit your doctor if eyelid problems persist over a long period of time.

TYPES OF EYELID DISEASE

There are many different types of eyelid disease. They include the following:

  Ptosis – Ptosis is drooping or falling of the upper eyelid. This condition generally affects the line of sight of an individual. Ptosis is usually caused by the following factors- age, nerve damage or trauma. Ptosis can affect children as well as adults and is usually treated surgically.
  Dermatochalasis – It is a medical condition in which the eyelid skin becomes loose or redundant. This condition is common in adults and is typically treated by blepharoplasty. Sometimes when the condition is severe enough to block vision, most insurance company will cover the cost of Upper eyelid dermatochalasis. Discuss this with your doctor at the time of your appointment.
  Brow ptosis – Brow ptosis is a common condition in old age, which causes the eyebrows to drop or sag. Brow ptosis repair involves an internal brow elevation (browpexy), a direct brow lift or an endoscopic forehead lift. It is always a good idea to discuss these options with your doctor prior to treatment.
  Ectropion – It is a common condition in the later part of life, in which the eyelid is turned outward away from the eyeball. This exposes the inner portion of the eyelid as well as the eye to the air. This escalates the dry eye symptoms, such as blurry vision, tired, burning eyes, red eyes, and red eyelids and sometimes tearing.
  Entropion –It is a common condition in which the eyelid is turned inward. This is very uncomfortable, as it causes the eyelashes to rub against the surface of the eye, which leads to irritation and poor vision. It is important to treat this condition, as it may cause permanent damage like scarring and vision loss.
  Eyelid retraction – This condition causes the upward displacement of the upper eyelid or downward displacement of the lower eyelid. This exposes the sclera- the white part of the eye. Various factors such as -scarring, prior surgery, graves disease can cause eyelid retraction, which leads to decreased vision and irritation. This in turn affects not only the quality of vision but also the health of the eye.

TREATMENT

Eyelid problems/ disease can be treated with different surgical method. The information below gives you an idea of different types of surgical and other options available to correct the eyelid defects.

Oculoplastic surgery- This surgery deals with the eye socket, eyelids, eye reconstruction, tear duct, and the face. There are different types of eyelid surgery such as blepharoplasty; plastic surgery of the eyelid to remove excessive skin and ptosis repair for the droopy eyelids. Orbital reconstruction, which includes procedures such as ocular prosthetics; artificial eye replacement and browplasty, can also be performed.

Blepharoplasty- Blepharoplasty is an operation to correct the defects and disorders of the eyelid. This surgery involves procedures that remove excess tissue from the hooded upper and puffy lower eyelids. This surgery also helps in correcting poor vision caused by increase in hooding. One can also use this surgery for aesthetic purpose, in which the excess tissue is removed to restore a youthful and elegant appearance.

Upper blepharoplasty- Upper eyelid blepharoplasty is normally performed under local anesthesia. This procedure involves outlining the excess tissue which is to be discarded, making a short skin incision in the nature skin crease and shaping the layers of muscle and fat. This surgery focuses on removing the excess tissue and retaining the eye comfort.

Lower blepharoplasty- Lower eyelid blepharoplasty can be performed underboth local anesthesia and general anesthesia. In this, only small amounts of skin, muscle and/or fat are removed from the lower eyelids.

Brow Lift- Brow lift corrects the droopy eyebrows, known as ptosis. It involves tightening of the forehead tissues, which helps in restoring a youthful appearance. Sagging of eyebrows can interfere with the visual function, and hence it is important to treat this condition. It is a common problem in old age.
The surgery starts with evaluating the appearance of the forehead, eyebrows, upper eyelids and peri-ocular region. Lines of the forehead, how active the eyebrows and the movement of the eyelids are also assessed. According to the findings, the surgeon then recommends the brow lift surgery.

Brow pexy- Brow pexy is an indirect approach, which is used to correct eyebrow ptosis. It is done most often in conjunction with an upper eyelid ptosis repair, or blepharoplasty. The brow pexy procedure is done through the upper eyelid. In this procedure, an incision is made along the natural crease of the eyelid. This incision helps in accessing the brow area. Once accessed, the brow is adjusted to the desired height. The brows are then secured in place with the help of sutures.

Orbital surgery- Orbital Surgery is a treatment that is used to correct the conditions which affects the orbital areas of the eyes. The bony orbits contain the eye and eye muscles, as well as some cushioning fat, blood vessels and nerves. Due to various reasons, such as trauma, tumor, thyroid eye disease and inflammation etc, the orbits can get affected. This subspecialty of oculoplastics includes training in the management of orbital conditions. Thus oculoplastic surgeons are well aware of the anatomy and function of the orbital areas of the eyes. They are also well tutored in interpreting the radiology tests, which is often performed in the orbital conditions.