Eyelid Malposition Conditions
Dr. Lensink has twenty years experience treating a wide variety of conditions that affect the position of the eyelid. These conditions may impact your field of vision, cause pain or irritation and increase your sensitivity to light. It is important to treat these conditions in a timely manner.
Dermatochalasis
Dermatochalasis: Excess upper lid tissue
Dermatochalasis (der′mă-tō-kă-lā′sis), or excess skin of the eyelid (in this case, the upper eyelid) is both an aesthetic and medical concern. Hooding of skin over the eyes leads to a tired and aged appearance, often causing one to look far beyond his or her stated age. As the hooding progresses, it slowly and subtly causes loss of peripheral vision. People unknowingly raise their eyebrows to lift the excess skin out of the way in a subconscious effort to improve the field of vision. This may in turn lead to visual fatigue, headaches, and/or forehead wrinkles. Furthermore, decreased light entering the eye due to dermatochalasis also leads to difficulty seeing.
Dermatochalasis is treated by upper eyelid surgery, also known as blepharoplasty (blef′ă-rop′tō-sis). To learn more about our straightforward "5 STEP PROCESS" to surgically treat Dermatochalasis Click Here.
We are often asked when blepharoplasty to treat dermatochalasis is covered by insurance. The answer varies from one insurance carrier to another. In addition to symptoms, all insurance carriers determine medical necessity based on photographs and/or computerized visual field testing. In our experience, all carriers require at least a photograph demonstrating skin resting on the eyelashes. Most have more stringent criteria.
Since dermatochalasis is a condition of excess skin, it is technically not a condition of eyelid malposition. But because it is most often the condition present when people refer to "droopy lids" we include it here.
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Blepharoptosis
Blepharoptosis: Drooping upper eyelid
Blepharoptosis (blef´a-ro-to´sis), often contracted to "ptosis" (tō´sis) occurs when the upper eyelid fails to fully open. If comparing the eye to a camera, blepharoptosis would be comparable to a camera shutter failing to fully open. When this occurs, the eye is unable to receive adequate light. In adults, this leads to generalized difficulty seeing, loss of visual field, and fatigue related to the subconscious effort to open the eyes further. If not treated promptly in children, ptosis can lead to an irreversible condition known as amblyopia wherein the vision-processing part of the brain fails to develop properly, causing the affected eye to see poorly throughout life.
To learn more about our straightforward "5 STEP PROCESS" to surgically treat Blepharoptosis Click Here.
Surgery to correct blepharoptosis is called "blepharoptosis repair." It most often involves making a small incision hidden in the crease of the upper lid where the eyelid opening muscle (levator palpebrae superioris) is either shortened or reattached. Less often and in more severe cases the eyelid opening muscle is simply too weak to be surgically enhanced adequately enough to raise the drooping lid. In these situations, a "sling" must be surgically created underneath the skin to attach the eyelid to the eybrow muscle. This allows the lid to be raised when the eyebrows are raised.
Blepharoptosis surgery is typically performed to allow more light to enter the eye, improve field of vision, reduce visual fatigue, and enhance the aesthetic appearance of the eyes. In children, blepharoptosis may also be performed to correct amblyopia.
In adults, blepharoptosis is most commonly caused by loosening of the eyelid opening muscle from its attachment inside the eyelid. In children it is caused most commonly by failure of the eyelid opening muscle to develop normally. Less commonly, blepharoptosis is caused by other conditions such as paralysis of the eyelid opening muscle.
Entropion
Entropion: Inward-turning lower eyelid
Entropion (en-trō′pē-on), occurs when an eyelid turns inward. Under normal circumstances, soft moist tissues lining the inner eyelid provide a healthy environment for the surface of the eye. When the eyelid turns in (entropion), eyelashes and the keratinized scaly skin surface irritate and abrade the eye and cause significant disturbance to the very delicate surface of the eye. Symptoms include irritation, light sensitivity and pain. Infections and scarring of the eye surface can develop.
Entropion is treated by lower eyelid surgery, known simply as "entropion repair." To learn more about our straightforward "5 STEP PROCESS" to surgically treat Entropion Click Here.
Entropion has many causes, the most common being the aging process. Entropion can also be present at birth, and in some instances, infection may lead to Entropion.
Ectropion
Ectropion: Outward-turning lower eyelid
Ectropion (ek-trō′pē-on), is the term ascribed to the condition wherein the eyelid (nearly always the lower lid) pulls away from the eye. When this occurs, the very delicate front surface of the eye becomes dry and inflamed. Chronic infection and scarring of the eye surface may occur. When ectropion involves the inner corner of the lower eyelid, the tear drainage duct is drawn away from the eye, causing tears to run down the cheek.
As with entropion, the most common cause of ectropion is aging. It can however, be present at birth. It can also develop after facial muscle paralysis such as Bells Palsy or as an unintended consequence of surgery elsewhere on the face.
Ectropion is treated by lower eyelid surgery, known as "ectropion repair." One of several surgical techniques can be employed depending on the individual circumstances. To learn more about our straightforward "5 STEP PROCESS" to surgically treat Ectropion Click Here.
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Eyelid Retraction
Eyelid Retraction: Extreme upper eyelid opening
When the upper or lower lid is open too far, the condition is known as eyelid retraction. Unlike ectropion, the eyelid still lays against the eye as it should, but the lid is wider open than is desirable. This causes over-exposure of the eye. Symptoms include irritation, light sensitivity, and feelings of dry eye. Less commonly it can ultimately lead to chronic infection and/or scarring of the ocular surface.
Most commonly eyelid retraction is associated with Graves' Eye Disease, although there are a number of other causes.
Eyelid retraction is treated with a variety of outpatient surgical procedures, depending on the cause, severity, and associated circumstances. To learn more about our straightforward "5 STEP PROCESS" to surgically treat Eyelid Retraction Click Here.
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