There are many issues that affect the eyelids, from styes (chalazions), lumps/bumps (eyelid cysts and tumors), to drooping upper eyelids obstructing peripheral vision, and loose lower eyelids leading to tearing. Most of these problems are due to anatomical defects that are correctable with surgical procedures. Eyelid procedures are routinely performed on an outpatient basis, and sometimes can even be done in the office.
Eyelid lesions (also known as eyelid tumors) can be either benign or malignant. The vast majority of eyelid lesions are benign. Examples of benign eyelid lesions include eyelid cysts, skin tags, styes, or viral infections. These can present anywhere along the upper or lower eyelids. The most common malignant eyelid tumors are basal cell and squamous cell carcinomas, which usually present on the lower eyelids and other sun-exposed parts of the face. Rarer malignant tumors include sebaceous cell carcinomas and melanomas.
Eyelid lesions can usually be biopsied in the office under local anesthesia with minimal risk. Often, smaller lesions can be excised completely at the same time. If the diagnosis is malignant, surgery is usually required to ensure that the entire tumor has been removed. This can be done either with frozen section analysis, or with Mohs micrographic surgery.
Eyelid reconstruction after tumor excision requires surgical precision to ensure the eyelid functions properly after surgery. If reconstruction is not carefully performed, eyelid malpositions (ectropion, eyelid retraction) may occur. Dr. Yoon is highly trained as an ophthalmic plastic surgeon to treat these complex problems.
Ectropion is a condition where the eyelid turns outward away from the eye, such that it is no longer in contact with the eye. This can result in redness of the conjunctiva (the mucus membrane lining of the eyelid) due to exposure to the air and sun. It can also lead to persistent tearing. Ectropion is usually caused by laxity of the lower eyelid due to aging. It can also be caused by scarring related to prior surgery, skin cancer, trauma, or be related to Bell’s palsy.
Entropion is a condition where the eyelid rolls inward towards the eye. This can cause the eyelashes to rub against the cornea, and potentially lead to infection, scarring or even vision loss. It usually results in chronic redness, irritation, and tearing. Entropion is also typically caused by laxity and instability of the lower eyelid from aging. It can also be caused by scarring on the inner eyelid from prior infection or trauma.
Entropion and ectropion can sometimes be managed with topical lubricants. However, often times surgery is needed to repair the underlying anatomical problem. This usually involves a lid tightening procedure that repositions the eyelid to its normal position. This can be done on an outpatient basis using local anesthesia and monitored sedation.
Before & After
Ptosis means that the upper eyelid is “droopier” than normal. This condition can affect one or both eyes. It can cause difficulty reading or driving, particularly at night or in lowlight conditions, and it can even lead to headaches from the continuous use of the forehead muscles to compensate for droopy eyelids.
Before & After
Before & After
There are many causes of ptosis including nerve paralysis, trauma, tumors, or myasthenia gravis, but by far the most common etiology is an age-related stretching of the muscle that lifts the eyelid.
Dermatochalasis is the excess upper lid skin hanging over the eyelashes and eyelid margin. This is typically related to the decreased skin elasticity associated with aging.
Blepharoplasty and/or concomitant ptosis repair can be performed to correct for these problems. These procedures are performed on an outpatient basis and require about 1-2 weeks for resolution of bruising and swelling. Often these procedures can be covered by insurance if there is significant peripheral vision obstruction caused by the eyelid obscuring the pupil. These surgeries can also be performed as cosmetic procedures where fat debulking or repositioning can help rejuvenate one’s appearance.
There are many different causes of tearing. There can either be an overproduction of tears, or inadequate drainage. Overproducing tears is often due to underlying dry eyes, which causes reflex tearing. This can also be seen in allergic or infectious conjunctivitis or other ocular surface abnormalities. The inadequate drainage of tears can be related to eyelid malposition, prior sinus surgery or trauma, history of chemotherapy for cancer (e.g. Taxotere), infection of the tear sac (dacryocystitis), or blockage of the tear duct (nasolacrimal duct obstruction).
The treatment of tearing involves identifying and correcting the underlying cause.
Occasionally, tearing can be due to a combination of problems, and it takes a specialist to sort through these to come up with a proper treatment regimen. Dr. Yoon specializes in tear duct surgeries and state-of-the-art techniques. He is an expert in endoscopic approaches to addressing the tear duct, without leaving a visible scar.
Colvard-Kandavel Eye Center offers personalized eye care services for patients with routine and complex eye conditions.
Our team is here to help you make an appointment with the specialists that you need.