Defects of eyelids and eye areas

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Symptoms

Many changes to the eyelids and the areas surrounding the eye are mainly of a cosmetic character and apart from aesthetic problems do not cause any other difficulties to the patient. A symptom of dermatologic changes might be excessive tearing, which is a consequence of an outward turning of the eyelid edge (ectropion). Consequently, it causes a reversion of the lachrymal point from the surface of the eyeball. On the contrary, when the eyelid edge is turned inwards (entropion), the edge with the eyelashes turns against the eyeball and irritates both the conjunctiva and the cornea, causing burning and cutting sensations in the eye.

Causes

The majority of eyelid changes occur as a result of skin relaxation due to the aging process and, together with lipid storage, create overhanging skin folds that make small sacs above as well as beneath the eyes (blepharochalasis). Other eyelid defects include formation of tiny lipid sediments in the inner side of the upper eyelids (xantelasm) or inflammation of skin glands in the eyelid edges (sty or hordeolum).

Various subcutaneous (globular lipid storage – liposomes, red vessel conglomerates – hemangiomas etc.) or surface (corneous skin or pedicle – papillomas) changes may also appear on the eyelids and their surroundings. With age, bazalioma are quite common. These are scaly tumors often depressed in the center. They can spontaneously bleed and form scabs afterwards. Other types of growths on the eyelid or its surrounding can be solid or even corny spinalioma as well as malignant tumors formed from pigment cells – melanoma.

Examination

A doctor will examine you by inspection only, which means he will look at your face focusing on the structures around the eyes and eyelids, including the eyebrows and eyelashes. He assesses mainly the level of eye openness, eye movement and its position in the orbit.

Conservative treatment

In case of inflamed eyelid edges, burning, stinging, itching, dry eye syndrome (DES) etc. a doctor can recommend using special gels for eye hygiene. Such solutions dissolve and remove eyelid impurities and have simultaneously antibacterial effects, helping to maintain the correct pH level as well as moistening and soothing irritated eyelids etc.

Surgical treatment

Eyelid cosmetic surgery

After removal of the overhanging skin folds in the lower and upper eyelids, a blepharoplasty is performed. It is a type of cosmetic surgery in which the doctor, using a scalpel (electrocauter), removes excessive loose skin along with part of the lipid tissue. Then he strengthens the ocular muscle. The procedure is done on an outpatient basis and takes place in the majority of cases under local anesthesia. To seal the operative site (a stitch is made subcutaneously) a very fine sewing fiber is used which minimalizes scar formation. Due to the excellent blood supply to the eyelids and their surroundings, tissue healing is usually very fast.

Similarly, there is a type of cosmetic correction of the eyelid tissue used for removal of wrong lower and upper eyelid positions (ectropia, entropia) and for ocular muscle strengthening.

Electrocoagulation and Cryo-coagulation

Removal of pathological formations (tumors, papillomas, hemangiomas etc.) in the area of the eyelids and their surrounding is done by cutting them out, then sewing the wound up and, if needed, cosmetic skin correction as well. For cutting any formations out, a scalpel is used. For tiny growths, an electrocauter is used. The electrocauter is a device that allows tissues to be destroyed by heat formed from a high-frequency electric current. Thus, there is no bleeding. This device is used also for eyelash epilation, for eyelashes that are curled back into the eyes and cause irritation. In some cases, an alternative treatment can be Cryo-coagulation – destruction of unwanted structures by briefly freezing them (under very low temperatures). All procedures mentioned are done on an outpatient basis and under local anesthesia. A very soft sewing fiber is used for sealing the wounds in order to minimalize scar formation.

Equipment/devices used

Electrocauter

It is a device that enables tissue to be destroyed by heat formed from a high-frequency current, thus preventing bleeding. It is used instead of a scalpel for the removal of eyelid pathological growths.

Other instruments

Scalpel, scissors, tweezers and pean (surgical closure forceps) used, for example, to capture vessels.

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