The eyelid is a very complex organ and serves many functions :
1- Protection of the eye from outside trauma
2- Helps the drainage of tears into our nose
3- Keeps the conjunctiva covered to avoid dryness
Age, genetics, cancer, inflammation and prior surgery are the most common things that can affect eyelid function. For example, with age our upper eyelids can droop and interfere with our vision (ptosis), or the lower eyelid can become loose and cause dryness and excess tearing of the eyes. There are specifically designed surgeries for these types of problems, such as a ptosis repair or an eyelid tightening. In some cases tissue needs to me moved or “borrowed” from other areas in order to restore function.
Surgery for droopy lids or ptosis surgery is done by making an incision on the upper lid(s) and reattaching the levator muscle (which raises the upper lid) with internal sutures. There is also an approach done from the inside of the eyelid that can also raise the level of your eyelid or “open” your eye more. These two surgical approaches reset the eyelid position at a higher position, so as to improve your field of vision.
The other two most common eyelid problems are ectropion, entropion and trichiasis.
Ectropion is when the eyelid is turned out, exposing the white (sclera) of the eye and thereby can make the eye drier and cause tearing and discomfort. The cause of this problem can be from laxity of the tissues from aging or scarring after trauma, cancer or cosmetic surgery. The surgery to correct this problem will depend on the severity of the laxity and the scarring around the lid. In many cases tightening the lid may resolve the problem; the addition of grafts or flaps to perform the reconstruction and restore the lid position is not uncommon.
Entropion is an inturning of the eyelid, the most common cause is laxity of the eyelid from aging. This excess laxity causes an imbalance of the rotation of the eyelid and cases it to turn in. Many times the eyelashes are rubbing the surface of the eye (the cornea) – also known as trichiasis. The usual symptoms are feeling of discomfort in the eye, tearing, blurriness and feeling that there is “something in the eye”. The surgery can be done through an internal or external approach depending on the degree of laxity.
Trichiasis occurs when the eyelashes rub against the surface of the eye (cornea); this can be secondary to misdirected growth of eyelashes, entropion, scarring caused by trauma or infection, or birth defects.
Our plastic surgeons, Dr. Storch and Dr. Sarraga can talk to you about what procedures can help you.