| Cosmetic
Eye Surgery
Oculoplastics is
ophthalmic plastic surgery with cosmetic as well as medical
applications. This specialized area of ophthalmology deals
with plastic surgery as it relates to the eyes and their
surrounding structures. Eye plastic surgeons are
ophthalmologists who have completed additional training in
plastic surgery for the eye and the facial structures around
the eye. Because such surgery can affect one’s ability to
see, ophthalmic plastic surgeons are uniquely qualified to
perform this delicate surgery and also provide any care that
the eye itself may need. Physicians at The Eye Clinic have
the skills to perform a wide range of cosmetic and
functional oculoplastic procedures. Free consultations are
available for those procedures desired for cosmetic purposes
only.
Eye Lift
The skin of the eyelid
is extremely delicate, and is often the first area of the
face to show the signs of aging. As you age, the eyelid skin
stretches and wrinkles, muscles weaken and fat can
accumulate around the eyes causing a tired, puffy look. In
the upper eyelid, these effects of aging may produce a
feeling of heaviness and limit the field of vision. In the
lower eyelid, "bags" may form.
Fortunately, these
changes around the eye are among the easiest to correct with
oculoplastic surgery. A procedure called blepharoplasty is
designed to remove sagging skin and muscle from the eyelids
, and to eliminate "bags" on the lower eyelids by
trimming away excess fat bulges. The procedure is performed
on an outpatient basis with local anesthesia and mild
sedation medications. The small incisions required for the
procedure are closed with fine sutures which are removed a
few days later. The excellent healing characteristics of the
eyelid skin prevent any noticeable scarring.
Drooping
Eyelid
Ptosis
("toe-sis") is the medical term for drooping of
the upper eyelid, a condition that can be apparent at birth
(congenital) or develops with age (acquired). It can affect
one or both eyes. Symptoms of eyelid ptosis include:
- heaviness of the
eyelid,
- blurred vision
which is sometimes worse when reading
- headaches from
using the muscles of the forehead and scalp to raise the
eye lids
- in severe cases
patients may even hold their eyebrow up with their
fingers in order to see
Ptosis is corrected
surgically by shortening the muscle that opens the eyelid.
Eyelid Laxity and
Lash Disorders
Ectropion
Stretching of the
lower eyelid with age allows the eyelid to droop downward
and turn outward. Ectropion is the medical term used to
describe sagging and outward turning of the lower eyelid and
eyelashes. This condition can lead to excessive tearing,
crusting of the eyelid, mucous discharge and irritation of
the eye. In addition to aging, ectropion can also result
from scarring of the eyelid from burns, trauma, skin cancers
or previous eyelid surgery.
In some cases,
ectropion can be managed temporarily managed with
medications to help lubricate and moisten the eye. Surgery
is usually required to restore the normal position of the
eyelid and relieve the symptoms.
Entropion
Entropion also occurs
as a result of aging. It can also result from infection and
scarring inside the eyelid. Entropion is the inward turning
of the lower eyelid. When this condition occurs, the
eyelashes and skin rub against the eye, making it read,
irritated and sensitive to light and wind. It not treated an
eye ulcer may form.
In some cases, taping
of the lower eyelid to hold it in the correct position can
be used to "retrain" the muscles. A suture
technique may also be successful in achieving the same
results. In addition, several form of surgical treatment are
used to correct entropion and turn the eyelid outward to its
normal position, protecting the eye and relieving the
symptoms.
Trichiasis
Trichiasis is the
medical term for the misdirected upper or lower eyelashes
that turn inward toward the eyeball. This condition can
cause a corneal abrasion if not corrected. It is usually
caused by trachoma, a severe conjunctival eyelid and corneal
infection caused by a virus. It can also result from
scarring caused by burns, mechanical trauma or other severe
eye infections. Trichiasis can affect a single lash or a
segment of lashes.
Several treatment
options are used for this condition, depending on the
severity of the symptoms, including epilation, electrolysis,
laser treatment, cryotherapy and surgery.
Eyelid Skin
Cancers
Skin cancer often
involves the skin of the eyelid, including the eyelid
margins, corners of the eye, eyebrow skin or adjacent areas
of the face. It most often occurs on the lower eyelid and
adjacent face. These skin cancers usually appear as painless
elevations or nodules. Occasionally, the eyelashes are
distorted or missing. There may be ulcerations of the
involved area, along with bleeding, crusting and/or
distortion of the normal skin structure. Any of these
symptoms require immediate evaluation and possibly a biopsy
to confirm the diagnosis of skin cancer. The most common
types of skin cancers are basal cell carcinoma and squamous
cell carcinoma. Both types are relatively slow growing and
do not usually spread to other parts of the body. If they
are detected early and appropriately treated, there is an
excellent chance of removing the growth completely and
minimizing the amount of tissue affected. Sebaceous gland
carcinoma and malignant melanoma are more serious forms of
skin cancer because they may spread to other parts of the
body. These cancers require prompt, aggressive treatment
because of the threat of early spread.
There are two
important principles in the management of eyelid skin
cancers: complete removal and reconstruction. Complete
removal is critical to minimize the chances of recurrence.
Any form of treatment for eyelid skin cancer will leave a
scar, however, every effort is made to minimize scarring and
achieve optimal cosmetic results. Once the cancer is
removed, reconstructive surgery is usually necessary to
repair the removal site or to make a new eyelid. The goal of
surgery is to reconstruct the eyelid so that it regains its
original functions of protecting the eye and preserving
vision, and also has a satisfactory cosmetic appearance. The
healing process after surgery may take six months to one
year. Once the wound has healed, follow-up with your
physician is necessary to ensure that the cancer does not
recur.
Thyroid
Related Eye Disease
Graves’ disease is a
form of thyroid disease in which the thyroid gland is
hyperactive and the eyes are affected. Graves' disease may
develop at any age and in either sex, but it most often
affects women between the ages of 20 to 60 years of age.
When Graves’ disease affects the eyes, it causes the eyes
to bulge or appear red and swollen. The space between the
lids may widen and excess tearing and discomfort may occur
in either or both eyes. Patients may experience sensitivity
to light, blurring or double vision, inflammations or
decreased movement. The condition also causes the eyelids to
open more widely, exposing the front surface of the eyeball
beyond the eyelids, resulting in discomfort and excessive
tearing. Most patients with Graves’ disease typically
experience a period of six to 24 months of active disease
during which there is active inflammation, and the ocular
manifestations are changing. After this phase is completed,
the eye typically remains stable.
The effects of
Graves’ disease on the eyes are managed in a number of
ways depending upon each patient’s individual symptoms.
Initial treatment involves observation during the active
phase of the disease, patient education and lubrication of
the eyes. Your ophthalmologist works with your regular
physician to monitor and manage your thyroid status. Medical
management can include systemic steroids, orbital
irradiation and surgical treatment. Surgical treatment
involves multiple stages and treatment that can span over
months to a few years. In can include orbital decompression,
eye muscle surgery and eyelid surgery. Some patients require
only one procedure, but others may require several,
depending on their individual symptoms.
Botox
Injections
Deep frown lines can
give your face a haggard and continually unhappy look. In
addition, the muscles that cause those frown lines can be a
major cause of tension headaches. Botox injections offer a
non-surgical, simple and relatively painless alternative to
cosmetic surgery for this type of cosmetic problem. Botox is
the shortened name for botulinum toxin A, a purified protein
neurotoxin used to paralyze muscles causing unwanted
contractions. It is administered by carefully placing
injections next to or into muscles. In the face, Botox
injections work by blocking the action of the muscles
responsible for frown lines and crow’s feet, resulting in
smoother skin around the eyes and forehead. It takes just
minutes to inject in our office, and the results are visible
within 24 to 72 hours. The beneficial effects of Botox last
for several months. |
