In-Office Eye Procedures
Eyelid surgery is a common method of treatment for entropion (inward turning of the eyelid), ectropion (outward turning of the eyelid), ptosis (drooping of the eyelid), and some eyelid tumors.
Eyelid surgery is usually an outpatient procedure with local anesthesia. Risks of surgery are rare, but include asymmetry of the eyelids. Differences in healing between the eyes may cause some unevenness after surgery.
After eyelid surgery, a black eye is common but goes away quickly. It may be difficult to close your eyelids completely, making the eyes feel dry. This irritation generally disappears as the surgery heals. Serious complications are rare but include vision loss, scarring, and infection. To most people, the improvement in vision, comfort and appearance after eyelid surgery is very gratifying.
The eye is surrounded by small oil producing glands that help lubricate it. Occasionally, the gland becomes plugged, and a hard and sometimes painful lump called a chalazion (ch-lae-zee-on) forms.
The pimple-like chalazion is a small annoyance that can become a big problem. What starts out as a small annoying lump can become infected and cause great discomfort. They eye may become red, swollen and sensitive to light. In the worst cases, it can even effect eyesight, causing blurry vision. This is due to pressure placed on the eye from the inflammation (swelling) of the eyelid and the growing chalazion.
Luckily, most chalazion stay small and are just a minor annoyance. They can be treated at home with warm compresses and gentle messaging of the affected area to loosen the plugged oil glands. They often resolve on their own within a few weeks. Chalazion that are a greater nuisance or become infected can be treated with antibiotics and other medications.
In the worst cases, the chalazion can be surgically drained and/or removed in the doctor’s office. If the chalazion returns or if you have had them over a long period of time, your doctor may send the removed chalazion to a laboratory to be tested.
Blepharoplasty is a surgical procedure to repair excessive skin and “swelling” eyelids. It is becoming one of the most common elective surgeries performed. The apparent swelling is usually a natural result of the aging process or, less frequently, a result of a disease state that causes the muscles around the eyes to degenerate. Regardless of the cause, the face and especially the eyes are considered key to a person’s appearance. The desire to correct the cosmetically bothersome condition is very common.
The surgeon will first take pictures of your eyes, and will probably ask for pictures of you taken before the condition was present. A thorough history and physical exam to determine health status before the surgery will be taken. Sometimes only the skin is removed; at other times fat tissue is removed as well.
Certain conditions can make the procedure more risky, such as thyroid disease, dry eye syndrome, diabetes, heart disease including high blood pressure and certainly any eye disorders (cataracts, glaucoma). An ophthalmic exam will also be necessary to detect any eye disorders, and to measure vision and eye movement before the surgery.
Your surgeon will review with you the risks of performing the surgery. These include bleeding, infection, the general risks associated with anesthesia, and post-blepharoplasty risks such as:
- vision changes
- vision loss (including blindness; rare)
- worsening of dry eye
- chronic irritation
- permanent scarring
- ectropion – the turning out of the eyelid, or the pulling away of the eyelid from the eye, making complete closure of the eyelid(s) not possible.
Blepharoplasty is usually performed using local anesthesia, and is done on an outpatient basis. First, the surgeon will mark the areas of the eyelids that will be repaired. Next, the anesthetic will be injected into the skin and tissue surrounding the eyelid.
The surgeon begins removing the tissue by making incisions in the natural creases (crow’s feet) that exist around the eye. This will make the scarring almost invisible. Excess fat may be removed as deemed appropriate. The skin is then closed with tiny sutures. Topical antibiotic ointment is applied to the site, and sometimes cold compresses to reduce swelling. A bandage may or may not be applied. Due to swelling and effects from the anesthesia, you will need someone else to drive you home. Your vision may be affected for several days.
Immediately after surgery, you should keep cold compresses on the surgical site and use the prescribed antibiotic to prevent infection. Pain medication will be prescribed before you leave the medical facility. If necessary, you will need to wear glasses for vision correction for a couple of weeks – no contact lenses. Limit your physical activity until after your next doctor’s appointment. Your doctor will tell you when you can return to strenuous activities. Stitches may need to be removed within days after surgery.
Bruising should disappear in 2 to 3 weeks, and complete recovery and corrected appearance should be obtained in 4 to 6 weeks. The pink scars may not completely fade for 6 months to a year after surgery.