Ocular Plastic Surgery eyelid Eyelid surgery

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Ocular Plastic Surgery (eyelid)

Ptosis

What is ptosis?

Ptosis is the medical term for a drooping of the upper eyelid.

What are the symptoms of ptosis?

   •   Drooping upper eyelid(s)

This can deteriorate over time to the point that it becomes difficult to see out
under the dropped eyelid.

What is the cause of ptosis?

Congenital ptosis is apparent from birth. This is usually due to abnormal
development of the muscle which pulls the eyelid up.

Acquired ptosis tends to become apparent in later life and may be caused by
ageing changes, lid trauma, eye surgery, neurological or muscular conditions.

What is the treatment for ptosis?

A full eye examination is essential to work out the cause of the ptosis.

The treatment involves surgery to tighten the muscle that lifts the eyelid. A small
cut is made in the eyelid to reach the muscle. Ptosis repair is usually completed
under local anaesthesia in adults. One or both eyes may need to be treated.

Most patients tolerate the procedure very well and have a rapid recovery. The
bruising and swelling associated with the surgery will usually resolve in two to
three weeks. Some patients may need adjustment of the sutures to better align
the lid height.
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Ectropion
What is an ectropion?

An ectropion is where the lower eyelid turns outwards away from the eye. Part of
the inner surface of the eyelid can be seen. Both eyes are often affected.




What are the symptoms of an ectropion?

   •   The inner lining of the eyelid that droops forward may become dry and
       sore.

   •   Watery eyes. The drooping eyelid may prevent the tears from reaching the
       tear duct and the eye may become constantly watery.

   •   Damaged cornea. The eyes may not close properly. Therefore the cornea
       (the front of the eye) is not fully protected and may get damaged. A
       corneal ulcer may develop. The cornea is vital for vision and a damaged
       cornea may affect eyesight.

What is the cause of an ectropion?

In the UK it mainly affects older people where the small muscles around the
eyelid become weak. The ageing eyelid stretches and can flop outwards.

It may also be caused by any condition that causes scarring of, or near the
eyelid. Generalised weakness of the facial muscles (facial palsy) may also include
weakness of the eyelid and cause an ectropion.

What is the treatment for an ectropion?

The usual treatment is an operation to 'tighten' the skin and muscles around the
eyelid. The surgery is usually with local anaesthetic and as a daycase.

Most patients experience immediate resolution of the problem once surgery is
completed with little if any post-operative discomfort. Most cases will require
subsequent removal of sutures located along the lower eyelashes or the lateral
corner of the eyelid. Minor bruising or swelling may be expected and will likely
resolve in one to two weeks following surgery.
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Entropion
What is an entropion?

An entropion is where the lower eyelid turns inwards and the eyelashes rub
against the eye. Both eyes are often affected.




What are the symptoms of an entropion?

   •   The conjunctiva and cornea can become sore due to the eyelashes rubbing
       against them.

   •   Watery eyes.

   •   Damaged cornea. A corneal ulcer may develop. The cornea is vital for
       vision and a damaged cornea may affect eyesight.

What is the cause of an entropion?

In the UK it mainly affects older people where the small muscles around the
eyelid become weak. The eyelid stretches over time and flops inwards.

It may also be caused by any condition that causes scarring of the conjunctiva.

What is the treatment for an entropion?

The usual treatment is an operation to 'tighten' the skin and muscles around the
eyelid. The surgery is usually with local anaesthetic and as a daycase.

Most patients experience immediate resolution of the problem once surgery is
completed with little if any post-operative discomfort. Most cases will require
subsequent removal of sutures located along the lower eyelashes or the lateral
corner of the eyelid. Minor bruising or swelling may be expected and will likely
resolve in one to two weeks following surgery.

More extensive plastic surgery may be needed in severe cases.

Whilst awaiting an operation you may be shown how to use sticky tape to help
pull the eyelid downwards and prevent the eyelashes rubbing against the eye.
                                                            0800 234 3937



Epiphora (watery eye)

What is a watery eye?

Most eyes are capable of watering when we are upset, for example or in a cold
wind. A watery eye is one that is watering excessively and interfering with the
patients normal activities.

What are the symptoms of a watery eye?

   •   Excessive tearing, especially indoors and when driving.

   •   Constant dabbing of the eyes.

   •   Sore excoriated skin under the eyes.

What is the cause of a watery eye?

There are either too many tears being produced, or the tear drainage pathway is
not working properly or may be blocked.

Excessive tear production is linked to eye irritation, for example due to ingrowing
eyelashes, blepharitis (eye lid inflammation), inadequate oil secretions and
corneal ulcers.

If the lower eyelid is lax (sagging), or has an entropion or ectropion, the tears are
not transported into the drainage system and may overflow onto the cheek.

The drainage system itself starts with a small plughole in the upper and lower
eyelids close to the nose, continues to the tear sac and drains down a narrow
passage into the nose. Any part of this pathway can be blocked.

What is the treatment for a watery eye?

A full eye examination is essential to work out the cause of the watering. The tear
drainage duct can be syringed to determine if and where it is blocked. Sometimes
an Xray is performed (DCG) which involves injecting a dye into the tear duct so
that an Xray will show where the blockage is.

The treatment depends on the cause. Many causes of ocular irritation can be
treated quickly and easily. Others such as blepharitis may take longer to treat.

If the tear ducts are blocked then surgery is required to unblock them. If the
blockage is very close to the opening of the tear duct, then snipping open the top
of the duct (one-snip operation) may be helpful. If the blockage is further down
the tear ducts then a more major operation called a dacryocystorhinostomy is
required. This involves bypassing the blockage by opening the tear sac directly
into the nose. This can be done either under local anaesthetic with sedation or
under general anaesthetic. A single nights stay in hospital is often recommended
as there can be some post-operative nose bleeding.
                                                         0800 234 3937

Most patients experience immediate resolution of the problem once surgery is
completed with little if any post-operative discomfort. Minor bruising may be
expected and will likely resolve in one to two weeks following surgery.

				
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Description: Ocular Plastic Surgery eyelid Eyelid surgery