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When it comes to maintaining proper eye care, eyelids can be easy to overlook. The truth is that your vision, comfort and eye health are all integrally related to your eyelids and tear ducts.

On July 30th, Oregon Eye Specialists will welcome Dr. Omaya Youssef, a Fellow of the American College of Surgeons, to lead treatments for patients facing a variety of eyelid and lacrimal (tear drainage system) problems.

We caught up with Dr. Youssef this week to learn more about his practice area. Not only did he bring us up to speed on how eyelids and tear drainage systems contribute to holistic eye health, he also shared the science behind five common problems associated with these important elements.


“As an ophthalmologist, my focus area is oculoplastics – which is a fancy way of saying that I specialize in treating issues related to eyelids, tear ducts, and the orbital socket,” says Dr. Youssef.

“Throughout my career, I have seen first-hand how eyelid and lacrimal problems can affect eye health and quality of life. I encourage all of my patients to proactively look for ways to assess and treat these issues.”

Do you struggle with one of these 5 common eyelid issues?

Dr. Youssef spoke with OES about five eyelid problems he frequently encounters in his field, and the steps people can take when experiencing these issues.

  1. Drooping eyelids

    Drooping eyelids can be a significant cause of frustration for patients.“With age, our eyelid skin loses elasticity, causing obstruction of vision from sagging skin and drooping lids,” says Dr. Youssef. “We see drooping eyelids most often with elderly people – although it can occur at any age.”

    While this symptom is often associated with the natural aging process, it should be taken seriously. It’s important to consult your doctor in cases where drooping eyelids begin to affect your vision, or if one eyelid suddenly droops or closes – as this may signify a more serious issue.

  2. Eyelids turning inward (entropion) or outward (ectropion)

    Inwardly-rotating eyelids, or entropion, cause the eyelashes to rub up against the eye and leads to redness, irritation, and abrasions on the cornea – not fun for anybody. Even in cases where this issue may not present obvious symptoms at first, it can pose a serious threat to the cornea – including possible loss of vision – if left untreated.

    Outwardly-turned eyelids (ectropion) pose another threat to your eye health, if left untreated. The outward-turned eyelid can cause exposure keratopathy, where the eye’s surface becomes dry and exposed. This can cause redness, tearing, or discharge to occur. Keratinization can also occur, where the inside of the eyelid becomes rough and dry instead of soft and moist, irritating the eyeball.

  3. Teary or watery eyes

    “Many people experience dry eyes due to poor-quality meibum, a healthy layer of oil essential in slowing the evaporation of our tears,” explains Dr. Youssef. “Sometimes we compensate for our dry eyes by abruptly tearing (‘reflex tearing’), and this can become increasingly problematic if our eyelids are not properly positioned to divert the excess tears towards the inner corners where they drain into the nose.”

    Consequently, eyelids that are not properly positioned against our eyes will result in ineffective blinking, causing an uneven tear film distribution. Eventually, dry spots develop on the surface of the eyes, leading to blurred vision and a dry, gritty sensation.

  4. Skin cancer

    In our blog post covering 3 important reasons to protect your eyes from UV rays, we shared that 5-10% of all skin cancers occur on the eyelid. In fact, the eyelid region is one of the most common sites for nonmelanoma skin cancers, according to the Skin Cancer Foundation. As with any cancer, early detection is key when it comes to the eyelids. When the cancer is detected, it is imperative to surgically remove the tumor to prevent continued growth and invasion into nearby structures.

    “The eyelid is exceptionally susceptible to cancer due to the delicate nature of the skin around the eye,” explains Dr. Youssef.  “In comparison to the rest of the face, skin surrounding the eyes is significantly thinner and more vulnerable. And while nonmelanoma cancers typically spread slowly, eyelid cancers in particular pose serious risk to tissue damage to nearby ocular structures – or even blindness.”

  5. Blinking spasms (Blepharospasm)

    Abnormal blinking or twitching in the short term is relatively common and often clears up soon after the symptoms appear. However, if this behavior persists, you may be dealing with Blepharospasm, an abnormal, involuntary blinking or spasm of the eyelids.

    The cause of Blepharospasm is often neurological, which makes it difficult to cure. But several treatment options can reduce its severity and the occurrence of other symptoms including dry or gritty eyes, sensitivity to bright lights and sunshine, and a tendency for the eyelids to frequently feel heavy or tired.

Fortunately, these conditions are treatable

Eyelid issues may not seem like a big problem to most, but those that struggle with these problems understand the discomfort and dysfunction they can introduce at work or in your personal life. So what can you do about it?

“In the short term, you may find relief with at-home or over-the-counter solutions, such as artificial tears for dry eyes or darker environments for light sensitivity,” says Dr. Youssef. “However, if you start experiencing loss of vision, pain, or if eyelid problems are interfering with your daily life, you should share your concerns with a medical professional.”

Dr. Youssef is based out of Lake Oswego and sees patients at our 8 Portland and metro area clinics. Call today to schedule your appointment: 503-935-5580

The science behind 5 common eyelid and lacrimal issues

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