Eyelid surgery | Doctors & treatment information

When is medical eyelid surgery advisable?

Disorders of the eyelid muscles are often responsible for eyelid malpositions:

• Ptosis

In the case of ptosis, one or both upper eyelids droop. This results in a restricted field of vision and, in severe cases, reduced vision. This is because the drooping eyelid covers the pupil.

This malposition has various causes:

• Disorder of the eyelid levator muscle (levator)
• Disorder of the accompanying nerve
• Diseases of the entire muscle system
• Poisoning as a result of a snake bite or spoiled food
• Decreasing skin elasticity with increasing age

Depending on the cause,different ophthalmologic therapies can be used to eliminate the primary cause. In the context of medical eyelid surgery, a common starting point is the shortening and tightening of the eyelid levator muscle.

In young children, corrective surgery should be performed as early as possible to prevent visual impairment from developing.

If the visual axis is covered, this is an emergency that must be treated quickly. The visual axis is the direct line of sight between the point of sharpest vision and the fixating object.

Incomplete ptosis of the right eye @ Angelina /AdobeStock

• Entropion

Entropion (also known as a rolled eyelid) is an eyelid that is turned inwards. This disorder usually affects the lower eyelid. This causes the eyelashes to rest on the eye and rub, which leads to a permanent foreign body sensation in the eye.

Itching, stinging and redness can also occur. If the disorder persists, inflammation, ulcers, scarring and a reduction in visual acuity can result.

Corrective surgery takes about 10-15 minutes.

• Ectropion

Ectropion is an eyelid that is turned outwards. The lower eyelid is usually affected. The lower eyelid is not directly attached to the eyeball, but protrudes a little from the eye. It hangs downwards.

This disorder is usually acquired and not congenital.

The causes are

• Slackening of the muscles due to increasing age
• Paralyzed nerve in the eye, which also leads to muscle relaxation
• Injury to the eyelid, which causes the eyelid to move after scarring

As the eyelid is not in contact with the eye, the tear fluid cannot drain away via the tear troughs at the inner corner of the eye . The eyes overflow and those affected often have to wipe their tears. Conjunctivitis is often the result.

This corrective procedure is also completed after around 10-15 minutes.

• Chalazion

A chalazion, better known as a chalazion, is a painless,slowly developing inflammation at the edge of the eye. The cause of the inflammation is usually blocked sebaceous glands. The inflammation often heals on its own in a few months or years, even without treatment.

To rule out a malignant ulcer, you should have it examined. In the case of larger chalazions or if treatment is unsuccessful, doctors can surgically remove the inflammation with medical eyelid surgery.

The procedure takes about 10 minutes.

Chalazion on the upper eyelid @ Heiko Barth /AdobeStock

• Eyelid tumor

Tumors can also occur on the eyelid. The most common malignant tumor that occurs on the eyelid is basal cell carcinoma , a skin cancer. Doctors remove this tumor surgically.

Preparation for medical eyelid surgery

Medical eyelid surgery is advisable if:

• There is a disease of the eye area
• There are restrictions and/or quality of life issues
• Conventional treatment is not possible

You should consider the following before undergoing eyelid surgery:

• First discuss your medical history with the surgeon and whether you have any allergies to medication or latex.
• Tell him whether you are taking any medication. You may have to stop taking them beforehand .
• The surgeon will tell you what you need to bear in mind before the operation. If you smoke, you must stop temporarily .
• Stop taking blood thinners such as aspirin 10 days to two weeks before medical eyelid surgery. Your doctor can advise you on this.
• On the day of the operation, you should arrange to be picked up from the clinic as you are not allowed to drive.
• Wear loose and comfortable clothing so that you can slip into a surgical gown quickly.
• Make sure you wear a loose-fitting top so that the anesthetist can give you an infusion.

Risks and side effects of eyelid surgery

Complications rarely occur during medical eyelid surgery. However, they cannot be ruled out. Undesirable effects can also occur during the healing process.

Below are some possible risks and side effects:

• Infections
• Poor healing process
• Risks due to anesthesia
• pain
• Swelling
• Discoloration of the skin
• Dry eyes
• Blurred spots
• Visual disturbances
• Problems closing the eyes
• Blood clots
• Numbness
• Partial or complete loss of vision

Irritation

Small milia (grains of grit) may appear near the incision. Your eyes may itch, burn and feel dry.

Your vision may also be impaired for a few days. If these symptoms persist, you should contact your doctor.

Nerve damage

Every operation carries the risk of nerve damage. The eye area is very sensitive, so medical eyelid surgery can cause irritation.

You may feel cold, numbness or a tingling sensation in your eyes. These symptoms usually disappear on their own.

Bleeding

Excessive bleeding is a common side effect of medical eyelid surgery. The incision may begin to bleed, especially if you suffer from a coagulation disorder or anemia.

In addition, a retrobulbar hematoma can develop very rarely. In this case, blood collects behind the eye, which can result in blurred vision or even blindness.

Scarring

Occasionally, some people are left with scars after medical eyelid surgery. The scars usually appear at the incision site. at the ophthalmologist

Visible scars will fade over time . However, if an infection develops after medical eyelid surgery, a larger scar may remain.

Procedure and aftercare of eyelid surgery

You will receive a local injection of a sedative and anti-anxiety medication to help you relax. Alternatively, you will be sedated via infusion, which also leads to a twilight sleep-like state.

During medical eyelid surgery, the surgeon uses a CO2 laser, an electrocautery device with a needle or a scalpel.

Although every patient recovers differently, you should allow at least half a week for recovery.

Observe the following tips during recovery:

• Keep your head elevated, even when sleeping
• Apply cold compresses
• Do not take aspirin or anti-inflammatory medication. If you are in pain, your doctor will prescribe a remedy
• Apply the antibiotic ointment recommended by the doctor to the operated tissue
• Expect swelling and bruising
• Refrain from wearing make-up for a week
• Avoid physical exertion during the first few days after the operation
• Expect to have blurred vision at times and be sensitive to light
• Protect your eyes with dark sunglasses
• Contact your surgeon if you experience poor vision, new pain or a sudden negative change in appearance

The surgical stitches will be removedafter one week. By this time, the bruising will have subsided.

The last visit to the ophthalmologist is scheduled after three months. The healing process should be complete by then. The final photos for the before and after comparison are usually taken at this appointment.