Ectropion is a “turning out” of the eyelid. Typically occurring on the lower eyelid, the skin of the inner lid is exposed, either in one section of the eye or across the entire lid. This prevents tears from draining from the eye correctly, resulting in irritation.
Common causes of ectropion include age-related weakening of the connective tissue around the eye, sun damage, tumors, burns, and the removal of too much skin during blepharoplasty. In some cases, ectropion occurs as a congenital birth defect or as a result of facial palsy.
Artificial tears can help provide temporary relief from dryness, but for full correction of ectropion, a quick surgical procedure is usually necessary. The area is numbed with a local anesthetic and sometimes light sedation is provided as well. For ectropion due to muscle weakness, the surgery may involve the removal of a small section of the eyelid to tighten the muscles in the area. When the ectropion is caused by scars or prior surgery, the procedure typically relies on a skin graft to allow a repositioning of the eyelid.
A functional blepharoplasty is performed to improve sight by lifting droopy eyelids out of the patient’s field of vision.
The procedure is usually performed as outpatient surgery with local anesthesia and lasts 45 minutes to a few hours depending on how much work is done. Incisions are made along the eyelids in inconspicuous places (in the creases of the upper lids, and just below the lashes on the lower lids). The surgeon removes excess tissue through these incisions and then stitches them closed with fine sutures. In the case that no skin needs to be removed, the surgeon will likely perform a transconjunctival blepharoplasty, where the incision is made inside the lower eyelid and there are no visible scars. The effects of blepharoplasty can last for a long time and are sometimes even permanent.
Eyelid Lesions & Chalazions
Eyelid lesions can have a wide variety of causes. While a lid lesion is most often benign, and its removal more for cosmetic reasons, there is a small percentage that the cause of the lesion is more serious. If necessary, the excised lesion will be sent away for further analysis. After local anesthesia, an instrument is put in place and an incision is made to remove the lesion. Alternatively, your ophthalmologist will use a cauterizing instrument to excise the lesion.
A chalazion forms when an oil-producing gland in the eyelid becomes enlarged and clogged. A chalazion may resolve with warm compresses, lid scrubs, and lid massage. When there is no improvement, the chalazion may be incised and drained. After local anesthesia, an instrument is put in place and an incision is made in the inner aspect of the eyelid. The contents of the chalazion are then carefully drained followed by gentle pressure or heat to control any bleeding. A steroid injection may also be used to aid in healing.