Eyelid and Orbital Plastic Surgery
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
Ptosis: Upper Eyelid Droop
A child with congential 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
(Eye M.D.) 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
Involutional ptosis develops with aging. It may worsen
after other types of eyesurgery 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
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 upper or lower eyelids may improve appearance. If excess
fatty tissue is present, it may be removed at the same time.
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.
If entropion is not treated, an ulcerous infection may develop
on the clear 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 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.
The 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
to close your eyes completely. This irritation generally disappears
as the surgery heals.
Serious complications are rare. The risk of losing vision
to be less than one in 5,000 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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