Eye Conditions Cured by Oculoplasty – Ptosis, Ectropion & Entropion

An elderly woman is undergoing eye check up

Looking great every day is one of the top things in everyone’s checklist when they go out. Eyes are the primary contact of one person with another and hence taking extreme care of them is very important. There are several problems which may harm our eyes not only from inside but from outside as well.

Below, we discuss three such issues which are most common but can easily be treated with a procedure called occuloplasty, popularly known as the plastic surgery of the areas around the eyes.

Ptosis

Ptosis (pronounced toe’ sis), or drooping of the upper eyelid, may occur for several reasons such as: disease, injury, birth defect, previous eye surgery and age. In most cases, it is caused by either a weakness of the levator muscle (muscle that raises the lid), or a problem with the nerve that sends messages to the muscle Children born with ptosis may require surgical correction of the lid if it covers the pupil. In some cases, it may be associated with a crossed or misaligned eye (strabismus). Left untreated, ptosis may prevent vision from developing properly, resulting in amblyopia, or lazy eye. Patients with ptosis often have difficult blinking, which may lead to irritation, infection and eyestrain. If a sudden and obvious lid droop is developed, an ophthalmologist should be consulted immediately

Signs and Symptoms

The causes of ptosis are quite diverse. The symptoms are dependent on the underlying problem and may include:

  • Drooping lid (may affect one or both eyes)
  • Irritation: Difficulty closing the eye completely
  • Eye fatigue from straining to keep eye(s) open
  • Children may tilt head backward in order to lift the lid
  • Crossed or misaligned eye
  • Double vision

Detection and Diagnosis

When examining a patient with a droopy lid, one of the first concerns is to determine the underlying cause. The doctor will measure the height of the eyelid, strength of the eyelid muscles, and evaluate eye movements and alignment. Children may require additional vision testing for amblyopia.

Treatment

Ptosis does not usually improve with time, and nearly always requires corrective surgery by an ophthalmologist specializing in plastic and reconstructive surgery. In most cases, surgery is performed to strengthen or tighten the levator muscle and lift the eyelid. If the levator muscle is weak, the lid and eyebrow may be lifted. Ptosis can usually be performed with local anesthesia except with young children.

Ectropion

Patients with ectropion have a sagging lower eyelid that leaves the eye exposed and dry. It is caused by a lack of tone of the delicate muscles that hold the lid taut against the eye. Excessive tearing is common with ectropion, but wiping the tears away causes the eyelid to sag more. Ectropion is most common among people over the age of 60.

Signs and Symptoms

  • Irritation
  • Burning
  • Gritty, sandy feeling
  • Excessive tearing
  • Red, irritated eyelid

Detection and Diagnosis

Ectropion can be diagnosed with a routine eye exam.

Treatment

The irritation can be temporarily relieved with artificial tears and ointments to lubricate the eye; however, surgery to tighten the lid is usually necessary to correct this problem.

Entropion

Entropion, an eyelid that turns inward, is a problem that typically affects the lower lid. It usually stems from a muscle spasm; however, it can also be caused by scarring from trauma or inflammation from certain diseases that involve the eyelids. When the eyelid turns inward, the lashes rub against the eye, resulting in irritation, scratchiness, tearing and redness. Surgery is often required to correct the problem.

Signs and Symptoms

  • Tearing
  • Burning
  • Irritation
  • Sandy, gritty feeling
  • Red eye

Detection and Diagnosis

Entropion can be detected during a routine eye exam. A slit lamp microscope is used to examine the effects of the in-turned eyelashes on the surface of the eye.

Treatment

The most effective treatment for entropion is surgery, although some patients find temporary relief by pulling the lower lid down with a piece of tape. Artificial tears are also helpful to ease the irritation caused from rubbing the lashes against the eye.