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
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 growths 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.