Blepharoplasty (Eyelid Surgery)
Several factors such as aging, sun damage, smoking, stretching and obesity can cause the eyelids to droop and sag as the supporting tissues weaken. This area of the face is often one of the first to decline, as the skin of the eyelid is thinner than other areas of the face. Eyelids that droop or bulge can affect peripheral vision, making certain normal daily activities, such as driving, more difficult.
If the eyelids begin sagging into the field of vision, a functional blepharoplasty, or eyelid surgery, may become necessary. This procedure can be covered by medical insurance if it is visually significant. A determination of how much this condition affects vision is done by checking the peripheral visual field with an instrument called the Humphrey Visual Field (HVF) Analyzer.
An upper blepharoplasty will tighten the muscles and tissue as well as remove excess fat and skin from the upper eyelids. A blepharoplasty can eliminate the drooping of the skin into the visual field, improving peripheral vision tremendously.
Cosmetic blepharoplasty can be performed on either the upper or lower eyelid or both. If no skin needs to be removed, a transconjunctival blepharoplasty can be performed, in which the incision is made inside the lower eyelid so there are no visible scars. This procedure has no affect on vision, but offers a younger, more refreshed look that reflects across the whole face.
Ectropion & Entropion Repair
Ectropion is a “turning out” of the eyelid that causes redness, irritation, tearing and an increased likelihood of infection. Common causes of ectropion include aging, sun damage, tumors, burns and the removal of too much skin during blepharoplasty. Ectropion can be corrected in a quick procedure in which the lid is tightened. Occasionally, the surgeon needs to graft a small segment of skin to ensure that the eyelid is fully repaired.
Entropion is a “turning in” of the eyelid. The lid and lashes rub painfully against the cornea. Entropion usually occurs as a result of aging, but other causes can include injury and various inflammatory conditions. Entropion can be corrected with a brief surgical procedure under local anesthesia.
Lid Tumor Removal
Tumors on the eyelid or orbit (eye socket) should be evaluated and treated as soon as possible. Most cancers of the eyelid (about 85-95%) are basal cell carcinomas that form on the inside of the inner eyelid. They are malignant but only rarely spread to other parts of the body. Treatment is usually surgical removal.
Lid Lesion Removal
Surgical excision is recommended for malignant (cancerous) and certain benign (non-cancerous) lid lesions.
Chalazions are cysts, or fluid-filled sacs, on the edge of the eyelid that can usually be treated with antibiotic eye drops and warm compresses. In cases when there is no improvement and cyst remains, the chalazion can be excised.
A pterygium is a raised growth in the surface of the eye (the conjunctiva) made mostly of collagen and tiny red capillaries. They are usually caused by extended exposure to sunlight. They may remain stable after appearing, or they may grow and affect vision.
Treatments include eye drops for irritation and redness, protection from sunlight and dust to prevent the pterygium from worsening, and occasionally steroids to lessen inflammation.
If the pterygium grows into the central cornea, surgical removal is recommended. This prevents the pterygium from altering the cornea’s shape and affecting vision.
Retinal Tear and Hole Repair
The vitreous is a clear liquid that fills our eyes and gives them shape. When we are young, the vitreous has a thick, gelatinous consistency and is firmly attached to the retina. As we age, the vitreous thins and separates from the retina. Although this usually results in nothing more than a few harmless floaters, tension from the detached vitreous can sometimes cause holes and tears in the retina. These retinal tears and holes can be sealed with a treatment called laser photocoagulation in which highly focused beams of light seal the tissue around the tear or hole in order to prevent fluid from entering the break.
Dry Eye Treatment
Dry eye occurs when the eyes aren’t sufficiently moisturized, leading to itching, redness and pain. The eyes may become dry and irritated because the tear ducts don’t produce enough tears, or because the tears themselves have a chemical imbalance.
People usually begin experiencing dry eye symptoms as they age, but the condition can also result from certain medications, conditions or injuries.
Dry eye is not only painful, it can also damage the eye’s tissues and impair vision. Fortunately, many treatment options are available.
Non-surgical treatments for dry eye include blinking exercises, increasing humidity at home or work, and use of artificial tears or moisturizing ointment. If these methods fail, small punctal plugs may be inserted in the corners of the eyes to limit tear drainage, or the drainage tubes in the eyes may be surgically closed.