Eyelid Problems at Baltimore Washington Eye Center serving greater Baltimore & Washington, D.C.

Eyelid Ptosis

Ptosis is an eye condition in which there is drooping of the eyelid. There are several possible causes of eyelid Ptosis. First, sometimes there is an excess of upper eyelid skin and prolapsed fatty tissue in the eyelid that is associated with aging. This can mechanically weigh down the upper eyelid and cause it to droop. This is considered a functional Ptosis, as long as the upper eyelid maintains a normal position and functions normally. When it is the actual eyelid that is drooping, whether or not it is associated with excess upper eyelid skin, Ptosis becomes the diagnosis. Ptosis that occurs as a result of the aging process is the most common cause. There are, however, other reasons for Ptosis. There is a specialized muscle that is responsible for elevating the eyelid. Over time, it can stretch or detach from its insertions and can allow the upper eyelid to maintain a lower posture when the eyelid is opened. In this instance, the normal upper eyelid crease may appear to have migrated upward. Patients with this problem may display strong contraction of their eyebrow muscles, giving them furrow lines. While most patients don’t realize that they are doing this, they may experience significant fatigue over the course of a day. Patients with this condition may appear chronically tired or angry. Not only can this affect a patient’s appearance, but it can also significantly impair the upper and peripheral visual field. Sometimes patients don't even notice this, as the central vision, which is used for reading, is not affected. Other causes of Ptosis may be mechanical due trauma or previous surgery or tumors of the eyelid depending on their location. A condition call Myasthenia Gravis may also cause droopy upper eyelids. Strokes or other neurological damage to nerves of the face and eyes may also present with or have an associated, droopy eyelid. There are several other rare causes of droopy eyelids. When evaluating your Ptosis, Baltimore Washington Eye Center Ophthalmic Plastic Surgeon Chimene Richa, M.D. might perform special measurements and tests. She will possibly take photographs and order a visual field test. Visual field testing will assess whether the droopy eyelid is impairing the upper or peripheral visual field. If you are an appropriate candidate, surgical correction of Ptosis can be performed on an outpatient basis at the Baltimore Washington Eye Surgery Center by Ophthalmic Plastic Surgeon Chimene Richa, M.D.

Eyelid Ectropion

The lower eyelid has several important functions. It maintains contact with the surface of the eyeball itself, thereby protecting the inferior surface of the eye. It also holds the tear lake to allow the upper lid to grab tears during a blink and sweep them across the eye in order to keep it moist. In addition, it also serves to direct the tears toward the tear drainage system. The normal position of the lower eyelid is tightly positioned against the eyeball, and its upper edge is normally just at the inferior edge of the cornea. There are several reasons for the lower eyelid to develop an abnormal position. The most common is simply the effect of aging and gravity. Over time, the lower eyelid can stretch and become lax, and no longer sit in the proper position. It may roll outward or droop downward, and the white part of the eye may show beneath the cornea. Symptoms may include irritation associated with drying out of the corneal surface, because the tear film is no longer in the proper location. This may be accompanied by excessive tearing. The tearing may be caused as the eye tries to protect the corneal surface and as the tears are not being directed toward the tear drainage system. If the lower eyelid is turned outward, the eyelid margin may become thickened and irritated as the mucosal surface dries out. This can lead to further irritation and scarring of the tear drainage system. As explained above, the most common cause of Ectropion is simply aging and gravity. Usually, this can be simply corrected by tightening the eyelid with a simple surgical technique.

Other causes of Ectropion include, scarring of the skin associated with skin cancers, other skin conditions, and previous surgeries. The correction of these types of problems may require specialized techniques including skin grafting. The lower eyelid may sag or maintain an abnormal position when the nerve input to the muscle is damaged. This can occur with strokes, facial nerve palsies or Bell’s palsy. Correction in these situations may require more specialized techniques that are performed by Baltimore Washington Eye Center Ophthalmic Plastic Surgeon Chimene Richa, M.D. and in almost all cases can be performed at the Baltimore Washington Eye Surgery Center.

Eyelid Entropion

Entropion is an abnormal in turning of the eyelid. When this occurs, the eyelashes and the skin of the eyelid can rub against the surface of the eyeball and cornea and cause serious damage. The irritation caused by this problem can be quite significant. There are several causes of Entropion. The most common cause is simply a laxity of the lower eyelid as the aging process and effects of gravity occur. Specialized muscle in and around the eyelids may loosen or weaken, allowing the eyelid to maintain an abnormal position. Most of the time, correction of this problem requires a simple same-day surgical technique performed by Baltimore Washington Eye Center Ophthalmic Plastic Surgeon Chimene Richa, M.D.  at the Baltimore Washington Eye Surgery Center. Other causes of Entropion may include certain conditions which cause scarring of the conjunctiva, chronic use of certain topical medications, some types of chemotherapy, burns and injury.

Baltimore Washington Eye Center Ophthalmic Plastic Surgeon Chimene Richa, M.D. provides examination, diagnosis and treatment of Ptosis or Droopy Eyelids, Ectropion and Entropion and is conveniently located for patients from Arbutus, Carney, Clarksville, Columbia, Dundalk, Edgemere, Essex, Ellicott City, Ferndale, Glen Burnie, Kenwood, Laurel, Linthicum, Lutherville, Odenton Owings Mills, Reisterstown, Towson, Timonium, Parkville, Randallstown, Rivera Beach, Pasadena, Severna Park, South Gate, Towson, Timonium and Woodlawn Maryland. To schedule an appointment for and examination or consultation for Ptosis or Droopy Eyelids, Ectropion or Entropion please call us at 800.495.3937.