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Eyelid Conditions

DROOPY EYELIDS

With Dr. Bruce Goldstick’s addition to the team at Eye Physicians, we are now able to offer our patients treatment for their eyelid problems. Droopy Eyelids are the most common eyelid complaint we see, and the symptoms can be very frustrating. They can cause a heavy feeling to the eyes, and can make them feel excessively tired. They can also make reading difficult due to the lids wanting to close when looking down at a book or newspaper. Droopy eyelids can even make a person seem like they are always ‘in the dark’, since the low hanging eyelids can act like a baseball cap pulled way down over the eyes. Of course, droopy eyelids can also be cosmetically unappealing.

There are actually two different causes for droopy eyelids — DERMATOCHALASIS and PTOSIS (toe-sis):

DERMATOCHALASIS is the more common cause of droopy lids, and it simply refers to excess skin that is hanging over what is an otherwise normal eyelid. Sometimes, this extra skin can hang all the way down onto the eyelashes. This extra skin covers over one’s ‘eye shadow space’ — meaning that in order to apply eye shadow, the person would have to lift the extra skin out of the way just to see the lid underneath. The patient below shows severe Dermatochalasis of the left eye, with mild to moderate Dermatochalasis of the right eye.

DERMATOCHALASISThe surgery to fix this condition is called a BLEPHAROPLASTY. This surgery consists of removing the extra skin (and sometimes underlying excess fat) under local anesthesia in the operating room. Interestingly, in the above photo, the patient has both upper AND lower lid Dermatochalasis. Lower eyelid Dermatochalasis is characterized by either excess skin under the eye or the lower lids bulging excessively from too much fat under the skin. This is also something is skilled at fixing.

PTOSIS occurs when the lid itself hangs too low, sometimes blocking the person’s pupil. Rather than too much skin hanging on top of the lid, with Ptosis the edge of the actual eyelid (where the lashes come out) is simply too low. This can make the person appear like they are always sleepy.

PTOSISPtosis is usually a problem of the muscles inside the lid. These muscles control the opening and closing of the eyelid, and sometimes get overly stretched out, like a rubber band that has become loose and no longer snaps back. PTOSIS REPAIR SURGERY tightens these eyelid muscles, thereby restoring the lids back to their normal height. Like Blepharoplasty, Ptosis repair is also done under local anesthesia in an operating room.

Once healed from either Blepharoplasty or Ptosis Repair, the patient often feels like they see better, their eyes no longer feel heavy or tired, and their world is literally brighter since the ‘baseball cap’ covering their eyes has been removed. They also have a more vibrant, rejuvenated appearance, that gets many compliments!

ECTROPION

ECTROPION is a condition where the lower lid becomes lax and turns outward away from the eyeball. This causes the tears to pool and overflow down the cheek, instead of the tears being held against the eyeball, where they need to be to lubricate the eye. This can lead to severe irritation, redness, tearing, and diminished vision. Many times, using artificial tears and gels can provide good relief for the patient. If this doesn’t help enough, then the only way to definitively cure the condition is with surgery.

ECTROPIONECTROPION REPAIR surgery tightens the eyelid, so the lid can be flush against the eyeball where it belongs. Ectropion Repair is done under local anesthesia in an operating room.

ENTROPION

ENTROPION is similar to Ectropion, in that it i s due to the lower eyelid becoming overly lax. However, with Entropion the lid turns inward against the eyeball. This causes the lashes to rub against the eye like a rake! This can be very irritating, causing pain, tearing, and even diminished vision. Like with Ectropion, we try to offer tears, gels and ointments to the patient to alleviate their symptoms, but if that doesn’t work well enough, surgery may be needed.

ENTROPION REPAIR surgery is also similar to Ectropion Repair surgery, in that by properly tightening the loose lower eyelid, the lid can return to its normal position with the lashes no longer rubbing against the eye. It is also done under local anesthesia in an operating room.

If you are being troubled by these, or any other, please come in to see for an evaluation. If your issues are found to be causing significant functional problems with your vision, or irritation to your eyes, then your insurance will even cover the cost of the surgery!