Oculoplastic Surgery

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Eyelid Surgery

Eyelid surgery (blepharoplasty) is the process of removing excess fat, muscle, and skin tissue from the lower and upper eyelids and tightening the parts around the eyes that support these tissues. With this surgical application, sagging, inward or outward turned upper and lower eyelids, bags due to excess fat collection, and wrinkles around the eyes are corrected.

WHAT IS EYELID DROOPING?

A droopy eyelid and a droopy upper eyelid are called "Ptosis". It is an eye problem that is present from birth or develops later due to various reasons and is seen as a drooping eyelid that covers the colored part of the eye more than a millimeter in length. Patients with droopy eyelids must be treated not only in terms of aesthetics but also because it will cause problems such as narrowing the visual field. In children, droopy eyelids can cause lazy eye syndrome. If lazy eye syndrome has developed, it must be operated on until the age of 6 years.

Although the disease can be seen in people of all ages, it can be congenital (congenital ptosis) or develop later.

Congenital disorders of the upper eyelid

Ptosis is the most common droopy eyelid among congenital disorders of the upper eyelid. In addition, there may be eyelid disorders such as adhesions on the eyelid (ankyloblepharon), inward (entropion) or outward turning (ectropion) on the eyelid edge, incomplete eyelid formation (coloboma), and extra eyelash row (distichiasis).

WHAT ARE THE SYMPTOMS OF EYELID DROOPING?

Droopy eyelids can often be caused by hereditary problems or muscle disorders.

Symptoms of patients with droopy eyelids may be as follows:

Trying to pull the eyelids up by raising his eyebrows
A tired and dull expression on the face
Dry eye or excessive tearing
Narrowing in the visual field

WHAT ARE THE TREATMENTS FOR EYELID DROOPING?

Treatment of ptosis is possible surgically. Since this problem is seen at all ages, treatment methods may vary according to age group. Generally, in pediatric patients, surgery is performed in order not to affect vision and amblyopia, and then the use of special glasses with occlusion treatment can be recommended and eye drops can be intervened. If the patient is an adult, the excess tissue on the eyelid that can be seen from the outside and even reduce the level of vision can be removed, or the muscle can be intervened to strengthen the muscle holding the eyelid.

When surgical intervention is required for droopy eyelids, treatment is performed by our doctors specialized in oculoplasty. The treatment is operations that take about 20 minutes and are usually performed under local anesthesia.

What are congenital disorders of the upper eyelid?

What are age-related eyelid changes?

With aging, drooping of the eyebrows and eyelids, turning inward or outward in the lower eyelid, bags or depressions around the eyes and wrinkles occur. These complaints can also be seen familial in younger people. Changes around the lid make the person look sad, tired, and sleepy. The treatment method is determined according to the type of problem.

What is an ingrown eyelash? (Trichiasis, Distichiasis)

Ingrown eyelashes occur congenitally (distichiasis) or after some eyelid diseases, as a result of the inward turning of the eyelid edge (entropion) or just the eyelashes (trichiasis). They damage the transparent layer of the eye called the cornea. Its treatment is surgery.

What is the treatment of congenital disorders of the eyelid?

Ptosis is the most common droopy eyelid among congenital disorders of the eyelid. In addition, there may be eyelid disorders such as adhesions on the eyelid (ankyloblepharon), inward (entropion) or outward turning (ectropion) on the eyelid edge, incomplete eyelid formation (coloboma), and extra eyelash row (distichiasis). The treatment of these diseases is surgery.

What is the inward turning of the eyelid? (Entropion)

Entropion, which usually occurs in the lower eyelid, occurs when the eyelid turns inward. Inward turning of the eyelid edge may be congenital or developed later. Surgical treatment is applied.

What is the outward turning of the eyelid? (Ectropion)

The outward turning of the eyelid edge usually occurs as a result of aging. It can also develop after congenital paralysis of the nerve that closes the eyelid (facial paralysis) and injuries. Surgical treatment is applied.

Is the treatment of facial paralysis possible?

Facial paralysis occurs when the nerve that provides the movements of the eyebrows, eyelids, and face does not work for any reason. In case of temporary paralysis, medical treatment is applied to protect the eye. In permanent paralysis, different surgical treatments are applied.

How are bags under eyes treated?

The most important reason for the formation of under-eye bags is genetics, namely heredity. The second reason is thyroid disease. Under-eye bags give the person an older and tired appearance. It is treated by removing excess fat tissues or changing their location.

Operations can be performed under local anesthesia and its effects last for a long time. Interventions on the lower eyelid can often be performed through the lid without the need to cut the skin. So, the problem of scarring or deformity in the lid after the operation is avoided.

What is brow lift operation?

Patients may have droopy eyebrows as well as excess eyelids. Generally, age-related or genetically, the outer sides of the eyebrows may fall due to gravity. This fall puts a load on the lid, creates excess skin on the lid, and spoils the aesthetic appearance.

In direct browpexy, an incision is made just above the eyebrows, parallel to the eyebrow hairs, and the eyebrow is lifted upwards. This incision can be made with a scalpel or carbon dioxide laser. Even if the incision scar is hidden for 3-6 months, some can be seen. It is rarely applied.

In internal browpexy, an incision is made from the lid line, as in the technique we call blepharoplasty. It is especially effective in drooping of the outer part of the eyebrow at the rate of 1/3. It is a method that does not leave any traces on the eyebrows.

WHAT IS BLEPHARITIS?

At the root of each of our eyelashes is a gland. These glands secrete and nourish and irrigate the transparent layer (cornea), the frontmost layer of our eye. Thus, our vision becomes clear.

These glands are narrow in some people. Glands, which we call meibomian glands, become infected due to stenosis. It causes dandruff at the bottom of the eyelashes, shedding of the eyelashes, and frequent inflammation, even by making a cyst on the lid, creating a CHALAZION.

Blepharitis is a chronic disease. The patient goes from doctor to doctor and looks for a cure. Each doctor gives a different antibiotic drop or cream, the patient thinks that he will be cured. However, the main treatment is HOT DRESSING and CLEANING THE EYELASH BASE EVERY MORNING. Some patients do eyelash cleaning at night due to the lack of time in the morning. The important thing is to clean the bottom of the eyelashes every day.

Blepharitis is very common in seborrheic patients and patients with rosacea.

TREATMENT:

Eye Relax device. The patient buys this device and applies it at home. With this device, the eyelids are heated for 5-10 minutes every morning or evening, and the meibomian glands are discharged. So, blepharitis is relieved.

IPL (intense pulse light) treatment. The patient is treated in the hospital with this device. The patient enters this device at intervals prescribed by the doctor (presumably once a week for 1 month or 3 months). With this device, the disease is treated by giving certain doses of energy to the meibomian gland and eyelids. It is also a technique used in dry eyes.

Hot dressing every day. Wash your eyelids frequently with hot water flowing from your tap every day. Hot applications such as shower, sauna, and spa relieve blepharitis. The more often you wash your eyelids during the day, the more comfortable you will be. This practice can be repeated even 20-30 times. If you want, you can also do this with cotton or fabric dipped in hot water.

Massage. After the hot application, press the lower lid eyelashes and empty the insides of the glands. Since the narrow orifices of the glands are opened with hot water, the ends of the glands will be emptied immediately with the massage.

Shampoo. You will feed the given shampoo to the roots of your eyelashes at night and go to bed without rinsing. Before this procedure, you must wash your eyelids with warm (as much as you can stand) water softening the glands at the eyelash roots.

Cleaning with medicated wipes. Since there is dandruff and shedding at the roots of the eyelashes, it is necessary to clean the roots of the eyelashes after dressing and massage with hot water every morning. Since S.aureus microbe and Demodex parasites settle at the roots of the eyelashes, cleaning with medicated wipes will quickly cure blepharitis. Medicated wipes are much more effective than eye shampoos, and when used together, the effect increases even more.

Antibiotic drops. If your doctor deems it necessary, he will give drops to eliminate germs and parasites. Use this drop as directed by the doctor. This period is usually 7 days. Then stop using the drops. Continue cleaning with warm dressing, massage, and medicated wipes.

Remember, blepharitis is a chronic disease. So, it can continue. Therefore, apply the instructions above for 3 months. When it repeats, apply the same steps. That's the cure.

Use of glasses. If you need glasses and you do not wear glasses, blepharitis recurs very often and cannot be cured. In this case, it would be better to use glasses or, if your eyes are suitable, to remove refractive error with an excimer laser.

Stress. Blepharitis and chalazion are more common in people who are stressed.

How should women use eye pencils and mascara? In female patients, blepharitis and chalazion are common in pen users because the roots of the eyelashes are covered with an eye pencil. If you have blepharitis or chalazion, we recommend that you completely remove the eye pencil from your life. Mascara, on the other hand, should only be applied to the tip of the eyelashes, not the roots of the eyelashes.

Briefly: APPLY SHAMPOO BEFORE SLEEP AT NIGHT AND CLEAN ROOTS OF THE EYELASHES WITH A MEDICINE WIPES IN THE MORNING

CHALAZION

Untreated blepharitis and stye (hordeolum) turn into a chalazion. If chalazion has occurred, there is NO TREATMENT OTHER THAN SURGERY. Since the surgery is done through the lid, no stitches are used and no scars are left. If chalazion surgery is delayed, it may infect other lids and require surgery for all lids. If chalazion has developed, have the surgery before 1 month. If you do what is explained in the treatment section above after chalazion surgery, you will prevent the chalazion from recurring.

What is almond eye plastic surgery?

In almond eye plastic operations, it is aimed to slightly raise the eyes. These operations, which have started to be performed quite frequently recently and make many women happy, provide a more aesthetic appearance to the face and eye area. Because of almond eye surgery, a completely new and aesthetic appearance is achieved on the corners of the eyes, where women are mostly applying the make-up and where deformations occur over time.

How is almond eye plastic surgery performed?

Almond eye plastic operations are performed under local and general anesthesia. Because of the anesthesia applied before the operation, there is no feeling of pain during the procedure. The operation is completed in about 1 or 1 and a half hours. It can also be performed in combination with operations such as upper and lower eyelid plastic operations and brow lift plastic operations. After the surgery, there is usually no pain, but bruising or swelling may occur. The average duration of these swellings is 5 to 7 days.

Prepared by the Dünyagöz Hospital Editorial Board.

*The content of this page is for informational purposes only. See your doctor for diagnosis and treatment.

Last Update Date: 02.06.2023