EYELID & TEARING PROBLEMS

Ptosis

Ptosis is a droop of the upper eyelid itself.

This is different than simply having stretched skin that hangs downward. A weak muscle within the upper eyelid causes ptosis. When severe enough the droopy eyelid will block upward vision and cause difficulty seeing. In some, the eyelid will close when reading. Some people are born with this condition while most people gradually develop ptosis with age.

Surgery corrects this condition by reattaching a loose muscle or shortening a weak muscle. It can be combined with cosmetic surgery to remove excess skin and fatty tissue.

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Entropion

Entropion is an inward turning of the eyelid.

This condition brings fifty or more eyelashes into contact with the eye. Symptoms can include severe irritation, tearing, light sensitivity and pain. If left untreated an ulcer may form. A muscle typically pulls loose inside the eyelid causing this problem.

Surgery reattaches the loose muscle and decreases any laxity of the eyelid. The eyelid is returned to a normal position. It is one of the most successful surgeries that we perform.

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Ectropion

Ectropion is an outward turning of the eyelid.

Since this exposes more of the eye to the air, typical symptoms include irritation, light sensitivity and tearing. The inside of the eyelid that is visible can become quite red. There are many causes of ectropion but the most common is a gradual stretching of the eyelid with age.

Surgery works by tightening the eyelid. The eyelid is pulled back into proper position where it can hug the eye and protect it.

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Eyelid Tumors

The eye can be subject to many types of growths.

Most of these are benign (not cancerous) but several types of cancers can occur. Sun exposure is the most common cause of these growths.

Since it can be difficult to tell benign from cancerous growths it is wise to have these examined. A biopsy is sometimes necessary to make a definitive diagnosis. Surgical removal is often indicated for suspicious growths or ones that are increasing in size.

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Dacryocystitis and Tearing

Dacryocystitis is an inflammation of the lacrimal or tear sac.

It is often due to a blockage of the nasolacrimal duct (the main drainage duct from the eye to the nose). The most common symptoms of dacryocystitis are tearing and a mucous discharge in the eye. At times, the eyelids will be stuck together in the morning. A tender area is sometimes present n the area between the eye and the nose.

Treatment of dacryocystitis often involves antibiotics taken by mouth. Although this will alleviate some of the symptoms, it will not relieve the blockage. Surgery is often necessary to bypass the blocked duct.

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Orbital Fractures

Orbital trauma can result in bones being broken around the eye.

This can occur from fights, automobile accidents and in many other ways. These are known as blowout or tripod fractures depending on which bones are involved. Not all orbital fractures need to be repaired. A careful examination helps determine when surgery is necessary. Symptoms can include double vision and a sunken appearance of the eye.

When necessary, surgery frees any trapped tissue from the broken bones. A thin plate is frequently placed to act as an artificial bone. At times, small metal plates are needed to hold bones together. Surgery will usually eliminate double vision and keep the eye in its proper position.

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Blepharospasm

Blepharospasm is an uncontrollable blinking and forcible closure of the eyelids.

It is more commonly known as Benign Essential Blepharospasm. Often the condition is progressive and a cause is usually not found. When very severe a patient can be prevented from driving a car or even walking due to their inability to keep the eyes open.

Several types of treatment are available. Injections of BOTOX® will usually control the symptoms for several months. When this is inadequate or repeat injections are inconvenient surgery can help. Surgery removes some of the muscles that spasm allowing the eyelids to remain open more easily.

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Orbital Disease

The orbit is the area surrounding the eye. It can have many problems.

These include tumors, infections, various inflammatory conditions and thyroid related problems. Symptoms can include pain, double vision and protrusion of the eye.

Prompt investigation of orbital problems is important. This can include CT or MRI scanning as well as a detailed office examination. At times a biopsy is necessary. Treatment can range from the use of antibiotics to oral steroids to surgical removal.

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Enucleation

Enucleation is the surgical removal of the eye.

It is performed when an eye has poor or no vision and has become painful. At times is also done to remove a dangerous growth within the eye.

The eye is removed and replaced by a round implant. This implant takes up space and helps prevent a sunken appearance after surgery. Once complete healing has occurred an ocularist fits a prosthetic eye. Remarkably good comfort and appearance are typically obtained.

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