Oculoplastic and lacrimal system disorder London UK

Oculoplastic and lacrimal system disorder

Ptosis (drooping upper eyelids)

When the edge of the eyelid falls and covers part of the pupil, it blocks the upper part of your vision. In severe cases, you may have to tilt your head back or lift the eyelid with a finger in order to see out from under the drooping lid.

This droopy eyelid, or ptosis, is generally age-related and occurs when the tendon that attaches the lifting muscle to the eyelid stretches, so the eyelid falls too low. Sometimes, there is a separation between the tendon and the muscle that lifts the eyelid.

It is not uncommon to develop a drooping eyelid after cataract surgery or long-standing contact lens use. A similar drooping may also affect the eyebrow and is known as brow ptosis — the word simply means downward displacement.

Ptosis can also be present at birth, or congenital. This form of the condition is often caused by poor development of the muscle that lifts the eyelid. If uncorrected, normal vision may fail to develop and the child may adopt an abnormal posture, with his or her head tilted backwards.

Excessive, involuntary blinking — blepharospasm

Excessive, Involuntary Blinking — Blepharospasm

Blepharospasm is excessive, involuntary blinking. Benign essential blepharospam, refers to this spasm in both eyes. Benign means the condition isn’t life-threatening and essential means that it is of unknown cause.

Some patients with blepharospasm may have associated twitching (dystonias) of the face and neck.

Many people are not greatly troubled by BEB but it can have a major impact on a sufferer’s life. Patients may be unable to drive, read, and watch television or work.

Eye bags / heavy eyelids.

Eye Bags/Heavy Eyelids

Tired-looking eyes caused by heavy eyelids or puffy, saggy under-eye bags are one of the most common complaints of patients contemplating cosmetic surgery.

Eyelid surgery, or blepharoplasty, can restore a more energetic and youthful appearance — you should look refreshed, as if you’re just back from holiday.

A blepharoplasty may be performed on the upper eyelids, the lower eyelids, or all four lids. It may also be combined with other procedures, such as a droopy eyelid lift, brow lift.

Skin cancer on and around the eyelid

Skin Cancer On And Around The Eyelid

Skin cancers are often found on or around the eyelid skin, most usually on the lower eyelid. They can also be found on the margins of the eyelid, corners, eyebrows or rarely near the eye on the conjunctiva (the inner lining of the eyelid).

They appear as lumps or elevations of the skin or as small swellings or nodules. In some cases, eyelashes are distorted or missing. The cancerous area may be ulcerated, may bleed or crust and the skin shape may be distorted. These cancers are painless. Diagnosis may need to be confirmed by taking a sample of skin (a biopsy).

Skin cancers are normally caused by excessive exposure to UV light — the sun or sun beds. The face, eyelids and arms are the main areas to be affected and fair-skinned people are much more likely to develop skin cancer than those with darker skin. Rarely, skin cancer can be an inherited condition.

Basal cell carcinoma is the most encountered skin cancer around the eye and it usually affect the lower lid and the medial canthus.

Treatment is usually with surgical excision, which is usually curative in this type of skin cancer when the excision is complete.

Facial Palsy

Paralysis of the facial muscle is due to the facial nerve pathology. Most of the time it is termed Bell’s palsy, which means that it is of unknown cause and it heals by itself in most of the cases.

When the facial palsy is permanent it would cause exposure of the eye, due to the inability to close the eye. As a result the eye would become severely dry which cause blurred vision, and in severe cases could cause loss of vision.

Treatment is usually surgical to enhance the closure of the eyelid and prevent dryness.

Inward-Turning Eyelid — Entropion

The medical term used to describe rolling inward of the lower eyelid and eyelashes towards the eye is entropion. The skin of the eyelid and the eyelashes rub against the front of the eye — the cornea — and the mucous membrane that protects the eye (the conjunctiva). This rubbing can lead to excessive tearing, crusting of the eyelid, mucous discharge, a feeling that something is in the eye, irritation of the cornea and impaired vision. In most cases, entropion occurs because of age-related relaxation of the tissues of the eyelid. Some cases result from scarring of the inner surface of the eyelid caused by chemical and thermal burns, inflammatory diseases or allergic reactions.

Outward-Turning Lower Eyelids — Ectropion

Ectropion is the medical term used to describe sagging and outward turning of the lower eyelid and eyelashes. This can lead to excessive tearing, crusting of the eyelid, mucous discharge and irritation of the eye. In most cases, ectropion occurs because of age-related relaxation of the tissues of the eyelid. Some cases are caused by scarring as a result of many years of sun-exposure, chemical and thermal burns, injury, skin cancers, or previous eyelid surgery.

Watery eyes

Watery eye could be secondary to a variety of reason, and does not always indicate a blockage of the tear duct. Dry eye and eye exposure could cause reflex tearing, which is an excess of the tear production to counteract the dry eye. Watery eyes could be related to lid malposition, mostly ectropion (the outward turning of the eyelid), as it causes the punctum (the opening of the tear duct in the eyelid) to face outward, instead of the inward, which is the normal position, hence the drainage of the tear would be suboptimal, causing watery eyes. Lid laxity, which is associated with the aging process or as a result of facial palsy, could cause watery eyes as a result of the suboptimal function of the pumping machine of the tear sac (Horner’s muscle). When a patient suffers from watery eyes, one should not presumed that it is due to blockage of the tear duct. Thorough examination of the ocular surface and eyelids should be taking place before considering ordering expensive diagnostic tools or having to put the patient under unnecessary invasive procedures.