Eyelid Surgery

Dr. Whitman: Welcome to Key-Whitman. Today we are going to talk about eyelid surgery. Both Dr. Jorge Corona and Dr. Ronald Barke perform eyelid surgery at Key-Whitman. Dr. Corona and Dr. Barke are oculoplastic surgeons who specialize in cosmetic and reconstructive eye lid surgery. Dr. Barke joins me today to help provide you some information about eyelid surgery.

Why choose an oculoplastic eye surgeon rather than a plastic surgeon for eyelid surgery?

Oculoplastic eye surgeons are eye doctors who are board certified in ophthalmology and who receive their fellowship in plastic surgery of all the tissues surrounding the eye. They are highly knowledgeable of the physiology and function of the eyes. By limiting their specialty to these areas, rather than generalized plastic surgery, they are acutely aware of the importance of balancing excellent cosmetic results while improving or maintaining the function of the eyes.

What are some of the common procedures performed on the eyelids?

Dr. Barke: Ptosis is the drooping of the upper eyelid. Most commonly due to aging, some patients experience problems with drooping lids after injury, after cataract surgery or other eye surgeries and even more rarely from tumors or other neurological problems. This condition may interfere with your vision and therefore would be considered a medical necessity and therefore should be reimbursable under your health insurance. There are tests to be done in the office to determine whether the condition is considered cosmetic or affecting your vision. The surgical treatment involves correcting the levator muscle to allow it to lift the lid properly and in some cases removing excess skin.

Dr. Whitman: Sometimes patients have a trouble with their lid turning in or turning out. When the lids turn out, we call this an ectropion. The lower lids sag or turn out sometimes due to aging, injury, eyelid growlths or facial paralysis. Due to exposure of the eye and the inability to close the eye fully, patients experience tearing, redness and discomfort. When the eyelid turns in, we call this an entropion. The turning inward of the lid causes the skin and lashes to rub against the eye. The cornea, the clear surface of the eye, is extremely sensitive to misdirected lashes and this also can cause redness, irritation and excess tearing. In both cases, surgery is performed to realign the lid to its normal position.

Dr. Barke: We may evaluate growths on the eyelids and face which may be benign (cysts, nevi, chalazions) or malignant (skin cancers). Upon examination, treatment with topical applications and/or warm, moist compresses may be advised or excision may be recommended. This often can be done simply in the clinic on the same day as your exam. The growth is usually sent to the lab to rule out a cancerous lesion.

Some patients may experience blockage of the tear ducts which may have been present at birth, or as a result of injury, disease or infection. Symptoms may include pain, discharge and excessive or chronic tearing. The tear sac may become acutely infected due to this blockage of the tear duct system. We may suggest warm compresses and antibiotics as a first course of treatment or we may perform irrigation in the clinic.The type of surgical repair depends on the age of the patient and location of the obstruction. One highly successful procedure involves the construction of a new "bypass" route connecting the upper tear ducts to the nose for drainage of tears.

After a serious blow or fall, some patients have fractures of the orbital bones which must be internally repaired to restore the alignment of the facial bones and the position of the eye within the orbit.

What about cosmetic eye lid surgery?

Dr. Whitman: For patients wanting to improve their appearance, cosmetic or elective eyelid surgery is available to provide patients with a more rested and youthful look. Eyelids may be raised to open up the eye area and extra fat and skin are removed to lessen puffy lower lids. We believe the oculoplastic surgeon is the best to perform eyelid surgery to prevent problems later with dryness if full eyelid function is affected.

I hope you find this information helpful and we look forward to taking care of you.

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