Eyelid Deformities

The eyelids can be affected by many abnormalities. The most commonly seen problems are ptosis (droopiness of the eyelid), entropion (the lid rolls inward), and ectropion (the lid rolls outward).

Ptosis

(TOH-sis) is a condition in which the upper eyelid(s) droops. This can be an acquired (develop over time), or congenital (present at birth). Acquired ptosis can worsen after other types of eye surgery, or after episodes of ocular swelling. Sometimes, excess skin (dermatochalasis) on the upper lids will cause them to droop. In either case, this droopiness can progress to a point where it interferes with vision, limiting peripheral (side) vision and even interfere with your ability to read or drive. When these symptoms are present, surgery to correct the problem is considered medically necessary. Surgery may be performed in the absence of these symptoms, but is generally considered cosmetic and not eligible for insurance benefits.

Congenital ptosis can affect visual development. A child with this condition may be seen tilting his or her head back in an effort to see. While it doesn’t always lead to poor vision, it is important to have the child seen to evaluate for related problems with visual development.

Treatment for ptosis is surgical. Additional testing will also be done to document the medical necessity of the procedure for insurance purposes.

Entropion

Occurs when the eyelid turns inward, and is most often associated with the aging process, but can also be secondary to infection or scarring. When the lid turns inward, the lashes rub on the clear surface of the eye (cornea), causing redness, irritation, and increased tearing. Left untreated, entropion can lead to significant discomfort, corneal abrasions, eye infections, and/or corneal ulcers.

Treatment for ectropion is surgical, although artificial tears or ointments may temporarily provide relief.

Ectropion

Occurs when the eyelid turns outward, exposing the normally protected inner surface. This condition is also commonly seen as part of the aging process, but can be caused by facial palsies (i.e. Bell’s palsy), birth defects (commonly seen with Down’s syndrome), or facial scarring. Left untreated, ectropion may lead to severe dry painful eyes, excessive tearing, chronic conjunctivitis, or keratitis (inflammation of the cornea).

Treatment for ectropion may include the use of artificial tears and ointments to relieve symptoms, but surgical correction is needed to correct the lid position.

Dr. Ballitch specializes in the evaluation and treatment of eyelid abnormalities. Surgery is performed in our onsite AAAHC certified surgery center.

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