Repair of a lower lid ectropion is typically done as an outpatient procedure. The patient usually gets a “local” injection of lidocaine (novocaine) and sedation although deeper anesthesia can be given if needed. The tendons of the eyelid in the corners of the eye are usually tightened with sutures through small incisions. The specifics are tailored to each patient's needs. Also, some patients may chose to have cosmetic “add-on” procedures performed at the same time as functional (insurance) surgery. For example, they may chose to have their lower lid fat bags removed knowing that this is NOT covered by insurance.
Repair of a lower lid entropion depends upon each patient's symptoms, unique anatomy, appearance goals, and ability to adapt to changes. Entropion repair only corrects the droopiness and sagginess but is not considered a cosmetic procedure. By correcting this droopiness of the lower lid, the surgery typically improves tearing and mucous discharge as well as the foreign body sensation that is caused by lashes rubbing the eye. Entropion repair does not improve blurred vision caused by problems inside the eye, or by visual loss caused by neurological disease behind the eye.
A blepharoplasty is the removal or repositioning of skin, muscle, and fat of the upper and/or lower lids. In the upper lid, the incision is made and hidden in the natural lid crease. The results of blepharoplasty depend upon each patient's symptoms, unique anatomy, appearance goals, and ability to adapt to changes. Blepharoplasty only corrects vision loss due to excess skin, muscle and fat that blocks the eye. By removing this excess skin, muscle, and fat that blocks the eye, blepharoplasty of the upper lids may allow more light in and improve your peripheral vision. Blepharoplasty does not improve blurred vision caused by problems inside the eye, or by visual loss caused by neurological disease behind the eye.
Ptosis is a condition that occurs when one or both upper eyelids droop and the edge of the upper eyelid falls towards or over the pupil . Ptosis is usually caused by stretching or thinning of the tendon between the muscle that raises the eyelid and the eyelid itself. With stretching or thinning, the muscle that normally raises the eyelid has to work harder to lift it. This leads to symptoms of eyelid and forehead muscle fatigue, and eyelid heaviness. Other, less common causes of ptosis are nerve or muscle damage from any cause, various types of eyelid surgery, infection, muscle weakness, and systemic diseases such as stroke and tumors behind the eye, myasthenia, hypertension, thyroid disorders and diabetes. Children can be born with congenital ptosis; the muscle is abnormally stiff and does not function well. This condition usually lasts until it is surgically corrected. Ptosis surgery is not the procedure of choice for removing excess fat and skin in the upper eyelid. Under certain circumstances it can be combined with the operation known as blepharoplasty when fat and skin removal is an added goal of surgery.
