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Eyelid Conditions

No one has perfectly symmetrical eyes. Often one eyelid lies a bit lower than the other or has some mark like a freckle that makes it appear different. That’s normal and nothing to be concerned about. However, there are eyelid issues that can impair vision and cause ocular problems that need to be checked out by a doctor and potentially repaired through surgery. Our team at Oregon Eye Specialists can examine your eye, offer a diagnosis, and repair the problem for any of the following issues:

Ptosis | Droopy Upper Eyelids

Some people have naturally drooping eyelids, a condition called ptosis. This drooping may hardly be noticeable, or it may be so severe that the eyelids begin to obstruct a person’s vision becoming inconvenient and uncomfortable.

The condition does not usually go away on its own and requires treatment by an eye surgeon to restore the eyelids to their normal position.

Eyelid Malposition | Entropion | Ectropion

Eyelid malposition is the abnormal positioning of the eyelids. The disorder is relatively common in aging patients but is something that should and can be repaired through surgery. A surgeon can reposition or anatomically and functionally reconstruct the eyelid.

There are two types of eyelid malposition:

  • Entropion is the inward turning of the eyelid, causing the eyelashes to brush against the cornea. Patients complain of eye pain, excessive tearing, redness, and irritation caused from the rubbing lashes. Left untreated, entropion could lead to permanent damage to the cornea and some vision loss.
  • Ectropion is the outward turning of the lower eyelid. As the lid sags away, the eye is exposed, and patients experience dryness and excessive tearing.

Eyelid Lesions and Skin Cancer

According to the American Cancer Association, skin cancer in America is considered a growing epidemic. Excessive sun exposure is the main culprit, but skin tone, genetics, smoking, and age are also contributors.

Any new eyelid lesion should be examined by a doctor.  While they are often benign, there are several types of skin cancers that appear around the eyelids and a lesion could be a first sign. An ophthalmologist can provide an accurate diagnosis based on a patient’s history and a clinical examination and be able to diagnose with a visual screening, but sometimes a biopsy may be required.

Unblocking Tear Ducts

A doctor will analyze your symptoms and irrigate the affected duct to determine the degree of blockage. A warm compress and antibiotics may temporarily alleviate some of your symptoms however surgical intervention is typically the most effective permanent treatment. One of the most common surgical solutions is a dacryocystorhinostomy (DCR). This procedure can be done externally or endoscopically without a need for a skin incision, thus avoiding the formation of a visible scar. Your doctor will create a new passageway and temporarily insert a Crawford tube to facilitate the flow of tears from the eyes to the nose. The Crawford tube will be removed in the office approximately 3 months after your surgery.


Eyelid Treatments

If you have been diagnosed with a condition impacting your eyelids, Oregon Eye Specialists can help.  Dr. Coleen Palileo is a comprehensive ophthalmologist and a fellowship-trained oculofacial plastic and reconstructive surgeon, who specializes in functional and cosmetic eyelid surgeries. These surgeries are offered to repair the damage and have you seeing clearly again:

Eyelid Reconstruction

While eyelid reconstruction is commonly needed after cancer treatments, it is also used for eyelid trauma and for conditions such as entropion or ectropion. Eyelid reconstruction can be used to maintain eyelid function and preserve vision. While there are differences in how complex the reconstruction is, the end result will be an aesthetically natural appearance.

Skin Cancer Removal

The most effective way to treat cancer on the eyelid is to completely remove it through surgical excision and then restore the natural appearance through eyelid reconstruction. Skin cancers that occur around the eyes must be handled delicately, but the required surgery is often performed on an outpatient basis with a local anesthesia.

Unblocking Tear Ducts

A doctor will analyze your symptoms and irrigate the affected duct to determine the degree of blockage. A warm compress and antibiotics may relieve the blockage but surgical intervention is the most effective treatment. The most common surgical solution is dacryocystorhinostomy (DCR). A small incision is made on the side of the nose and some bone is removed to make a space for a Jones or Crawford Tube that provides a new connection between the eye and nose to facilitate the flow of tears.

About Functional Eyelid Surgery

If vision changes due to eyelid conditions are making it difficult to work, read, drive, or keeping you from doing everyday activities you enjoy, it may be time to consider functional eyelid surgery.

When to have functional eyelid surgery depends on several factors, including:

  • Your needs and preferences
  • Your doctor’s evaluation
  • Any risks or other eye conditions
  • When your insurance covers surgery

At Oregon Eye Specialists, our ophthalmologists include some of the most experienced surgeons in the Northwest. Your surgery is done in a comfortable eye surgery facility with the latest equipment and an experienced, caring staff.

What is the surgery experience like?

Eyelid surgery is done with local anesthesia (numbing injection) and a light sedative (we don’t have to put you fully to sleep). You are generally very relaxed and comfortable. An anesthesiologist will be with you during the procedure to help ensure your safety and comfort.

During the surgery, your doctor makes an incision on your eyelids. Your doctor may request your participation during the surgery by opening and closing your eyelids so that appropriate adjustments can be made on the height and contour of your eyelids. Throughout the entire duration of your surgery, you will be very comfortable and you will not experience any significant pain. At the end of the surgery, your doctor may put in stitches and dressings that will be removed 1 week after your surgery. You can expect to have some bruising and swelling around the eyelids for one to two weeks after your surgery.

Talk to your doctor about whether functional eyelid surgery is right for you, and what some of the risks may include. Get ready for brighter days ahead!

If you have any eyelid conditions or another eye condition, we invite you to make an appointment today at one of our clinics. 



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