Treatment for eyelid conditions

There are a number of eyelid conditions that we can successfully treat, medically or cosmetically, including ectropion (eyelids drooping down), entropion (eyelids turning in) and cysts in the eye area.

I have a question about blepharoplasty for eyelid conditions

What are the most common eyelid conditions?

There are several eyelid conditions:

Ectropion (eyelids drooping down and turning outwards)

Ectropion usually affects the lower eyelid, where the eyelid droops away from the eye and turns outwards. Eyelid drooping can affect one or both eyes and is usually age-related. It's not usually a serious condition, but it can be uncomfortable when the tear duct constantly leaks fluid away from the eye, leading to ‘dry eye’.

Without treatment ectropion can, rarely, cause a corneal ulcer to develop on the eye's surface which could affect your vision.

Entropion (eyelids turning in)

Entropion is where the eyelids turn inwards, towards the eye; this can cause the lashes to irritate or damage the surface of the eye. It usually affects the lower lids, may occur in one or both eyes, and is often age-related. The irritation caused by entropion can be uncomfortable and rarely, if not treated, cause a corneal ulcer to develop on the eye's surface which could affect your vision.

Severe entropion can be painful, and when eye-drops are not effective at relieving the pain or if the condition is posing a risk to your eye health, surgery may be required.

Cysts or lumps in the eye area  

Lumps, cysts and styes can occur on or around the eyes or on the eyelids; they can be unsightly and irritate the surface of the eye. Most of these will be quite harmless and cyst or stye treatment won't be necessary but rarely, these could signal a more serious underlying condition, so you should always have these checked by your doctor who may recommend their removal.

How do you get a stye?

The causes of a stye aren’t always obvious, however most are a result of bacteria entering the eye glands or follicles. You can get a stye anywhere around the eye, including a stye inside the eyelid.  Keeping the area clean should make the stye disappear without the need of any ointments or medications.

Dry eye syndrome

Dry eye syndrome, which is usually age-related, occurs when the fluid created by the tear ducts no longer keeps the surface of the eye adequately lubricated. This may be because the tear ducts are not creating enough fluid, or that the fluid being produced is being lost from the eye, perhaps due to an eyelid abnormality. Sometimes surgery may be required to treat dry eye syndrome.

What causes eyelid conditions?

Ectropion and entropion are most often associated with getting older as the muscles and tissues of the eyelids become weaker. Sometimes there are other causes of ectropion and entropion, including:

  • A tumour, lump or cyst on the eyelid
  • An issue with the nerves controlling the eyelids (as seen in Bell’s Palsy, a type of paralysis of the face)
  • Damaged skin around the eyelid (for example, because of an injury, a skin condition, a burn, or previous surgery)

What are the symptoms of eyelid conditions?

Ectropion/entropion usually affects the lower eyelids, in one or both eyes. Symptoms include:

  • Sore, red and irritated eyes
  • Undereye twitching
  • Eyelid inflammation
  • Eyes watering excessively
  • Eyes feel dry and gritty
  • Bacterial eyelid infections (e.g. conjunctivitis)

How are eyelid conditions diagnosed?

Your GP or Optician (Optometrist) should be able to accurately diagnose your eyelid condition after a short examination and by discussing your symptoms.

What is the treatment for eyelid conditions?

Treatment options range from self-medication with eye-drops for mild cases. If this doesn’t work, your GP can refer you to our Consultant Ophthalmologists for further assessment or treatment, including blepharoplasty.

What is blepharoplasty?

Blepharon means eyelid and -plasty means to mould. Blepharoplasty is surgery to correct eyelid problems, including ectropion and entropion (drooping eyelids) and baggy eyelids.

It may be performed for medical reasons where the condition is causing discomfort or pain, or if it affects vision or poses a risk to the health of the eyes. Surgery may also be carried out for cosmetic reasons where a patient is not happy with the appearance of their eyelids.

Upper and lower blepharoplasty surgery is the most commonly performed cosmetic procedure in the UK. At Benenden Hospital, it’s performed regularly by our expert Oculoplastic Surgeons.

Why would I have a blepharoplasty?

You may have eyelid problems, including ectropion and entropion or baggy eyelids which may be causing discomfort or pain, or if it affects vision or poses a risk to the health of the eyes.

Surgery may also be carried out for cosmetic reasons where a patient is not happy with the appearance of their eyelids.

A blepharoplasty can treat excess upper eyelid skin – known as hooded eyes - particularly if it starts to affect your peripheral vision. And in the lower lids, blepharoplasty can reduce the appearance of eye bags.

What happens during blepharoplasty?

Surgery to correct eyelid conditions is usually a minor procedure that is quick and simple to perform. Surgery is usually carried out as day surgery so you’ll be able to go home on the same day, but you may not be able to drive yourself. You’ll be given a local anaesthetic, so you'll be awake but you won’t be able to feel any pain in the area of the operation.

The exact nature of your surgery will depend on what condition you have, its underlying cause and its severity.

What should I expect after blepharoplasty?

You may have some pain or discomfort after the operation which we’ll help you manage with painkillers. After surgery you may have padding over your eye to protect it. We’ll tell you how to care for your wound and, if you’ve had non-dissolvable stitches, we’ll make an appointment for you to have them removed. You may need to take some time off work.

How can eyelid conditions be prevented?

Aging around the eyelid area is very complex as the skin is so delicate. Age-related changes can be easily addressed with an operation but here are our top tips for keeping your eyelid skin healthy and preventing eyelid conditions:

  • Sleep on your back where possible
  • Don’t smoke
  • Wear a high factor sun cream, even in the winter and apply right up to the eye and on the upper and lower lid as these are high-risk areas for skin cancers
  • Wear sunglasses
  • Follow a healthy diet rich in foods that are good for eye health, such as leafy greens, carrots, kale, Omega-3 and zinc
  • Keep up with eyelid hygiene
Miss Elizabeth Hawkes

Watch our oculoplastic surgery webinar

If poor vision is stopping you from enjoying what you love, we can help. Consultant Ophthalmic and Oculoplastic Surgeon, Miss Elizabeth Hawkes and Eye Unit Sister, Jane Styche talk about treatments for eye and eyelid conditions.

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