Blepharoptosis, also referred to as ptosis, is defined as an abnormal low-lying upper eyelid margin with the eye in primary gaze. Treatment- -Mainly surgical, rarely medical and lid props in selected c.a ses Surgery is usually very successful in restoring appearance and function. Surgery is done as a day care procedure by an Oculopasty surgeon . The surgery does not involve any manipulation of the eyeball, hence the vision is not affected by this surgery. However in children if the surgery is delayed it may lead to subnormal vision (Amblyopia ).
Ectropion- Out turning of the eyelid margin.
Entropion- In turning of the eyelid margin.
Treatment- Primarily Surgical
Surgery is done on day care basis and involves tightening of the lids.
These surgeries don't affect the vision as they are performed on eyelids.
Lid retraction is when the eyelid opening is more than normal Lagophthalmos is when the eye remains open when closed normally Treatment- Mild cases- Lubricating eye drops and gels, Lid tapping at night Severe cases- Gold weight implants, Spacer gratis, Lid tightening procedures
Patient with long standing facial palsy showing lid retraction and lagophthalmos. The same patient with gold implant surgery.
The various options are
Cosmetic contact lenses
Enucleation/ Evisceration with implants
Dermis fat gratis/ Hydrogel implants in contracted sockets.
Cosmetic contact lens Used when there is no vision
Dacryocystorhinostomy (DCR) for watering and discharge
Probing for congenital nasolacrimal duct obstruction(CNLDO)
Pediatric DCR for CNLDO
Canalicular tear repair with minimonoka stent for canalicular lacerations
Orbitotomies for orbital space occuying lesions.
Exentration surgery for tumors
Orbital floor repair with prolene, titanium implants in trauma
Orbital decompression for thyroid ophthalmopathy.
Botox for dynamic wrinkles like crows feet, frown lines and forehead lines.
Fillers for volume loss like tear trough, nasolabial lines.
Surgeries- Upper and Lower Lid Blepharoplasty, Fat reposition.