ENTROPION

WHAT IS ENTROPION?

Entropion is a condition where the eyelid folds in towards the eyeball. The eyelashes rub against the surface of the eyeball causing irritation and discomfort. If entropion is left untreated, an infection may occur, or an ulcer may develop on the surface of the eye.

WHAT CAUSES ENTROPION?

Entropion is associated with advancing age, occurring most often in people over the age of 60. With increasing age, the eyelid becomes less elastic allowing it to flip inward.

WHAT ARE THE COMMON SYMPTOMS?

The most obvious symptom is the visible inward turning of the eyelid. There may be discomfort or pain in the front of the eye with excessive tearing and redness.

CAN IT BE TREATED?

In most cases surgical correction is necessary. The aim of eyelid surgery is to tighten the eyelid and pull it outward to its proper position. The surgery is a day procedure performed under a local anaesthetic.

ECTROPIAN

WHAT IS ECTROPIAN?

Ectropion is the outward turning, usually of the lower eyelid. The eyelid droops away from the eyeball so that the inner surface of the eyelid no longer touches the eyeball, but is exposed.

WHAT CAUSES ECTROPIAN?

Ectropion is most often associated with loss of muscle tone, and skin tone during the ageing process, causing the eyelid to stretch and become floppy. Ectropion may also be caused by neurological conditions or by any condition that results in tightening of the skin around the lower eyelid. Sun damage, for example, causes the damaged skin to contract and pull the lower eyelid down. Rarely, a person may be born with ectropion.

Constant wiping of a watery eye caused by ectropion may pull the eyelid further away.

WHAT ARE THE COMMON SYMPTOMS?

The most noticeable sign of ectropion is a saggy, outward facing lower eyelid. The affected eyelid is often red and swollen from exposure. The eye may be watery because the tear drainage tube is no longer in the correct position.

CAN IT BE TREATED?

Artificial tear eye drops may provide temporary relief of the symptoms of ectropion, but surgery is often necessary. There are a few surgical approaches involving horizontal tightening, vertical tightening, a skin graft or a combination of these. A small incision is made to tighten the skin of the eyelid. If the skin surrounding the eyelid is tight, then a skin graft may be necessary.

EPIPHORA

WHAT IS EPIPHORA?

Epiphora is the ongoing abnormal overflow of tears that may affect one or both eyes. It is a common condition frequently occurring in babies and the elderly. Epiphora is not the same as when the eye is temporarily teary from an irritant such dust or allergies.

WHAT CAUSES EPIPHORA?

A small amount of tears are produced by a gland on the outer edge of each eye. The tears are spread by blinking to help keep the eye moist. Excess tears drain through small holes on the inner edge of the eye into a tear sac and then through a duct, known as the nasolacrimal duct, into the nose. The production and drainage of tears is a balanced process. This balance may be disrupted either by overproduction of tears or decreased drainage of tears. When this happens, tears may build up and overflow, resulting in a persistently watery eye. There are several underlying causes that may disrupt the production and drainage of tears, but usually, it is a result of a blockage in one or both tear ducts.

WHAT ARE THE COMMON SYMPTOMS?

Epiphora is characterised by persistent excessive tearing that may be painful. The affected eye may be red, and there may also be excessive mucous or discharge along with the watery tears. There may be a tender feeling around the nose or sinus area.

CAN IT BE TREATED?

The cause of epiphora is treatable in most cases and will determine therapy options. If a blockage is the cause of epiphora, a small procedure, which involves passing a tiny probe, may widen the duct or clear the blockage. Syringing with saline may also help clear a blocked duct if the blockage is minor. If probing and syringing cannot clear a blocked duct, a surgical procedure, called a DCR (dacryocystorhinostomy), may be performed. This surgery creates a new channel from the tear duct to the inside of the nose, allowing tears to bypass the blocked portion of the tear duct. If entropion or ectropion are contributing to epiphora, tightening of the eyelids may help relieve the problem. No treatment is necessary if the condition is mild and not troublesome.

BLEPHAROPLASTY

WHAT IS BLEPHAROPLASTY?

Blepharoplasty is a surgical procedure to remove excess skin and soft tissue around the eye for cosmetic enhancement of appearance and correction of medical problems. Medical problems that are corrected with blepharoplasty include obstruction of vision by a droopy upper or puffy lower eyelid and malposition of the lower eyelid.

CONSIDERING BLEPHAROPLASTY

Several factors including age and degree of visual obstruction play a role in the surgical outcome of blepharoplasty. This procedure is usually uncomplicated, but as with all surgery, poor wound healing, infection or excessive scarring may occur. The eyes may be asymmetrical after surgery, but this can usually be corrected. Muscle damage may result in a droopy eye if the upper eye muscle is damaged, or double vision if the lower eye muscle is damaged. There may be eye dryness or difficulty in closing the eye if too much skin is removed.

WHAT TO EXPECT FROM THE PROCEDURE?

Blepharoplasty is performed under local anaesthetic and can take up to an hour. The choice of surgical technique will depend on the reason for the surgery.  The visibility of scars is reduced by making incisions in the natural creases of the eye. Excess skin and fat are removed, and the eyelid muscles tightened if necessary.

WHAT TO EXPECT AFTER SURGERY?

Recovery after surgery is usually quick.  There may be some tearing of the eyes or occasionally blurred vision, which will go away as the swelling subsides. Most people can return to work within a couple of days to two weeks depending on the type of work.