The proper functioning of the eyes also depends on the position and function of the eyelids. Additionally, the eyelids have a great influence on the appearance. The most common abnormalities of the upper eyelids are excess skin and hanging eyelids. The lower eyelids can - especially at old age - turn inwards or outwards. All of these abnormalities can cause eye irritation and deterioration of vision. Surgery can help to correct this.
A hanging eyelid (ptosis)
A hanging eyelid which arises in the course of your life can have several causes. At old age, it is often caused by the muscle which gradually releases from the eyelid. At younger ages, the muscle can also release, usually this is due to wearing hard contact lenses for a prolonged time. Rare causes of a hanging eyelid in adulthood includes muscle diseases and disorders of the nerves.
In both cases, adjustment is possible by making a small incision in the upper eyelid and secure the muscle under local anesthesia.
Blood thinning agents
Eyelid Surgery cannot be performed while taking blood thinners. These are medications that contain acenocoumarol or acetylsalicylic acid. Even if blood thinners are used which are used by the thrombosis service it is possible that eyelid surgery cannot be performed. Also, other drugs may have an impact on the operation.
Therefore report all the medications you are taking to your ophthalmologist.
In some cases it is possible that due to correction of the hanging eyelid problems are caused with regard to the closure of the eye. This can lead to pain and visual impairment due to dehydration of the cornea.
Operation of a hanging eyelid doesn’t deliver the desired result in some cases immediately. Reoperations are therefore not uncommon. When the difference in height between the two lids is 1 mm or less, the result of the operation is considered as a success.
An excess of skin in the upper eyelids (dermatochalasis)
Before the procedure it is outlined how much excess skin can be removed. The eye must be able to close well after treatment. You’ll be seated in a comfortable bed, after receiving anesthetic eye drops. The skin is removed by means of the CO2 laser. Subsequently, excess fat in the various layers will be found and removed. This can only be performed safely (meaning no blood loss) by means of the CO2 Laser. The advantage of the removal of fat is that the result is much better and that the result has a long-lasting effect. The opening through which the fat is removed is closed with a self-soluble continuous suture.
The skin is closed with nylon sutures and removed after 10-14 days.
After the treatment you will feel for a few hours a poignant feeling. Sometimes the eyelids are thick and blue. Immediately after the treatment thin paper patches are placed on the sutures. These can be removed the next day, after they are made properly wet (for example after a shower) .The sutures partially shed spontaneously and the remainder will be taken out after 10 - 14 days. It is recommended that the first night you apply a towel to your pillow (since wound fluid can leak). The first week after the treatment you should take it easy, do not exercise or do any heavy lifting. During the first days you can cool the eyelids best with a special cooling pack for 10 minutes three times a day. You should put this cooling pack in the fridge and not in the freezer. After the upper eyelid correction, you will receive the following:
- Appointment for the removal of the sutures
- Cooling pack and sunglasses
An exwardly turned lower eyelid (ectropion)
With the aging process the lower eyelid weakens horizontally. This may hang lower and tilt outwards. This may also be caused by scars or skin diseases.
An outward turned eyelid causes irritation, tearing, redness and sensitivity to bright light and wind. In addition, inflammation may occur.
In general, the ectropion can be corrected under local anesthetics.
An inwardly turned lower eyelid (entropion)
Also this deviation is usually the result of aging.
The eyelashes and the skin of the eyelid rub against the eye. This causes a red irritated eye, which is sensitive to light and wind. If the entropion is not operated on, there is a risk of corneal damage by abrasion of the eyelashes. Also inflammation can occur with an entropion.
In general an entropion can be corrected under local anesthetics.