Oculoplastic Diseases

Dermatochalasis/Ptosis (Droopy Eye Lids)

Many people, due to aging changes of the skin, experience droopy upper eyelids. This can be due to excess skin that tends to hang over and block upper or side vision. The muscle that controls the height of the upper lids tends to weaken with age, leading to the condition called ptosis. Brow ptosis sometimes goes hand in hand with the upper lid changes. Overall these changes lead to vision obstruction, constantly trying to “open” the eyes, and sometimes having to lift your head up to see.

Entropion and Ectropion

Age related changes in the skin and muscle of the lower lids can lead to turning in (entropion) or turning out (ectropion) of the lower lids.

These 2 conditions can cause tearing, redness, constant irritation, gritty sensation, and decreased vision. With entropion the eyelashes rub against the surface of the eye leading to the chronic irritation. With ectropion, the eyelid is turned away and droops down leaving the surface of the eye more exposed and prone to dryness and constant discomfort.

Chronic Tearing (Epiphora) from Tear Drainage Obstruction

Our eyes make tears 24 hours a day, 7 days a week so there is a system of canals that allow tears to drain from the inside corner of the eye into our nose. Any obstruction to this flow of tears leads to excessive tearing, and in certain cases, infection. As seen in the image, tears first flow to the inside corner and enter through two openings (the punctum) then flow to the lacrimal sac and down through a canal that opens in the nasal passage.

So from improper position the punctum to any obstruction in the canals will lead to the symptoms as mentioned above. That’s why a thorough eye exam is necessary to figure out what part of the system is obstructed. Tears that become trapped in the lacrimal sac can lead to over population of bacteria which causes infection (dacrocystitis). This condition requires oral antibiotics and eventual surgery.

Eyelid Lesions (Moles/Warts/Cancers)

Many benign (non-cancerous) lesions grow on the skin of our eyelids and also the margin of the lids. These can include wart-like growths to benign-looking moles. However, sometimes cancerous lesions can grow; the most common is basal cell carcinoma. Melanoma, though rare, can grow on our eyelids. So any suspicious growth should be evaluated and of course be excised or biopsied.

Chalazion/Hordeolum (Stye)

Blockage of the opening of the oil glands that line the margin of the eyelids lead to swelling/tenderness/redness which is the common stye. These usually are not infections but inflammation due to the stagnant oil that body’s immune system reacts to. Warm compresses along with certain eye drops and sometimes oral antibiotics might be necessary to treat the condition.