For complete eye health, your eyelids need to be as healthy as your eyes. Eyelid position is also important to your appearance. Excess eyelid skin, droopy eyelids or eyelids that turn inward or outward are common problems. They can cause eye discomfort, and even limit vision. Fortunately, such eyelid conditions are correctable by surgery.

Ptosis: Upper eyelid drooping

Ptosis: Upper eyelid drooping Ptosis ("toe-sis") is apparent at birth (congenital) or develops with age (involutional).

Ptosis is a condition where the upper eyelid droops over the eye.

After surgery, the upper eyelid is restored to its normal position.

A child with congenital ptosis may tilt his or her head backward in order to see, so it does not always lead to poor vision. However, children with ptosis should be examined by an ophthalmologist because they can have other associated eye problems.

Surgery to correct ptosis is commonly recommended in the preschool years to make it easier for children to see and to improve appearance. The type of surgery varies, depending upon how much the eyelids droop.

Involutional ptosis develops with aging. It may worsen after other types of eye surgery or eyelid swelling. Ptosis may limit the fiield of peripheral vision and produce an uneven appearance. Surgery corrects the problem by shortening the muscle that opens the eyelid.

Excess eyelid skin

Over time, many people develop excess eyelid skin. Eyelid skin is the thinnest skin of the body, so it tends to stretch.

In the upper eyelid, this stretched skin may limit the peripheral field of vision, and may produce a feeling of heaviness and a tired appearance. In the lower eyelid, "bags" form.

The excess skin in the upper eyelids can be removed surgically by a procedure called a blepharoplasty to improve the peripheral field of vision and other symptoms. Removal of the excess skin in either the upper or lower eyelids may improve appearance. If excess fatty tissue is present, it may be removed at the same time.

Excess eyelid skin may produce a heavy sensation
as well as limit the field of peripheral vision.

Ectropion: Outward turning of the lower eyelid

Stretching of the lower eyelid with age allows the eyelid to droop downward and turn outward. Eyelid burns or skin disease may also cause this problem. Ectropion can cause dryness of the eyes, excessive tearing, redness and sensitivity to light and wind. Surgery may restore the normal position of the eyelid, improving these symptoms.

Entropion: Inward turning of the lower eyelid

Entropion also occurs most commonly as a result of aging. Infection and scarring inside the eyelid are other causes of entropion. When the eyelid turns inward, the eyelashes and skin rub against the eye, making it red, irritated and sensitive to light and wind.

Normal eyelid Ectropion Entropion In these drawings, the eyelid is cut away to show the appearance of the normal eyelid (left), and the eyelid turning outward (center) and inward (right). If entropion is not treated, an infection with an ulcer may develop on the clean surface of the eye called the cornea. With surgery, the eyelid can be turned outward to its normal position, protecting the eye and improving these symptoms.

Eyelid plastic surgery

Eyelid plastic surgery is almost always performed on an outpatient basis using local anesthesia. Before surgery, your ophthalmologist (medical eye doctor) will perform an eye examination and make recommendations. Photographs and visual field testing are often required by insurance companies before blepharoplasty and ptosis surgery. If you are planning to have surgery, be sure to tell your ophthalmologist if you are taking aspirin or aspirin-containing drugs, blood thinners, or have a bleeding problem. This surgery is generally safe; however, as with any surgery, there are certain risks:

• The ophthalmic surgeon will attempt to make both eyes look similar, but differences in healing between the eyes may cause some unevenness in the appearance following surgery.
• A "black eye" is common, but will go away quickly.
• The eye may feel dry after surgery, because it may be more difficult to close your eyes completely This irritation generally disappears as the surgery heals.
• Serious complications are rare. The risk of losing vision is estimated to be less than one in 5000 surgeries. Infections and excessive scarring occur infrequently