Dermatochalasis (excess eyelid skin & fat)
With age, the upper eyelids can become loose and baggy, causing a reduction in the field of vision and interfering with important activities such as driving. This may be addressed with a type of surgery called blepharoplasty, which involves removing this excess tissue via small incisions hidden in the natural eyelid creases. Most insurance companies will require obtaining tests to demonstrate the degree of visual field restriction before authorizing this procedure. We also frequently perform a variation of this procedure for cosmetic purposes when the visual field is not obstructed.
Eyelid Lesions
There are many types of eyelid lesions, some can be observed safely while others should be biopsied or completely excised. Based on the appearance in consultation and your particular medical history, a decision can be made whether to observe, biopsy or remove the lesion. Some of the most common benign eyelid lesions are chalazion (stye), cysts, skin tags, and nevi (moles).
Eyelid Malposition (eyelids “turn in or out”)
The eyelids need to be in a normal position to ensure eye protection, for good tear production and drainage and to allow the eyelids to close properly with each blink. When the lids are malpositioned, they can be very irritating to the eye and result in tearing, pain, and chronic discharge. Entropion is a condition in which the eyelid is "turned in" toward the eye. Ectropion is a condition where the lower eyelid is “turned out” away from the eye. Both can be repaired with surgical procedures designed to return the eyelid to its natural position.
Eyelid Reconstruction (after cancer or trauma)
Eyelid reconstruction is often required following trauma or tumor excision. Depending on the degree and location, reconstruction can be performed using a variety of tissue flaps and grafts. In some cases, eyelid cancers are best removed surgically by a Mohs surgeon (dermatologist with additional training and expertise) who would be able to spare the greatest amount of normal tissue while maintaining the lowest rate of tumor recurrence. We have close relationships with Mohs surgeons in the area and would coordinate each patient’s care based on the specific circumstances of the case.
Facial Nerve Weakness (Bell’s Palsy)
Weakness of the facial nerve will lead to weakness on one side of the face. Depending on the severity of the weakness, the eyelids and eye itself can be affected. There can be weakness in blinking and closing the eyelids that can result in irritation, pain, and a potential risk for infection. Surgical and non-surgical techniques are available to protect the eye and provide symptomatic relief and functional improvement.
Ptosis (droopy eyelids)
Ptosis is the medical term for droopy eyelids. Drooping of the upper eyelid(s) can cause a reduction in the field of vision when the eyelid obstructs the visual axis. Children can be born with ptosis, while adults develop ptosis as a result of aging, prior surgery, or long term contact lens use. There are various methods of correcting ptosis depending on the type, degree and severity of ptosis. Recovery from ptosis surgery is usually quite rapid, and patients find themselves returning back to work within a few days.