Eyelid Surgery - Western Eyecare

Home » How To Qualify For Eyelid Surgery » Eyelid Surgery - Western Eyecare

Maybe your like

Eyelid Surgery
  1. Home|
  2. Oculoplastics|
  3. Eyelid Surgery

Eyelid Surgery is a large part of our practice, encompassing functional, aesthetic and tumour related surgery.

Details on the most common procedures including Blepharoplasty, Eyelid Malposition, and Ptosis can be found below.

Blepharoplasty - Excess tissue of the upper lids can affect peripheral vision or lead to a sensation of heaviness of the upper lids leading to tired feeling particularly late in the day.

The excess tissue is often eyelid skin compounded by weakening of the structures of the eyelid and advancement of orbital fat into the upper lid.

A thorough understanding of eyelid structure and function means an ophthalmologist with a special interest in oculoplastic surgery can address each contributory factor required for optimal functional and aesthetic outcomes.

Correction involves surgical removal of skin of an appropriate site and contour, removal or repositioning of eyelid and orbital fat as well as reformation of the skin crease to give a natural and youthful appearance to the upper lid whilst removing tissue affecting vision and eyelash irritation.

Bulky upper lids can be compounded by descent of the lateral eyebrow and drooping of the upper lid causing temporal hooding. These factors can be addressed in the same surgery.

FAQ's

Do I qualify for Blepharoplasty to be covered?

Medicare have set very strict criteria as of November 2018 for this procedure to be covered. Essentially one must suffer from a visual field defect, confirmed on visual field testing as well as meeting a criteria for eyelid skin overhang as evidenced by clinical photographs. Some inflammatory problems such as thyroid eye disease or floppy eyelid syndrome may qualify without meeting these standards. If you do not qualify, you can still have surgery in hospital however would need to cover the hospital, surgeon and anaesthetists costs out of pocket, or the procedure can be done in rooms under local anaesthetic only, at a lower cost.

How is Blepharoplasty performed?

Dr Slattery performs Blepharoplasty surgery either in an operating theatre under sedation with local anaesthetic, or in rooms with local anaesthetic only. Any excess skin, muscle or fat is removed via an incision hidden within the natural upper skin crease. Blepharoplasty is often combined with lifting of the eyelid (Ptosis repair), Eyebrow Lift or other procedures.

What happens after the Blepharoplasty procedure?

You will often be placed in the near sitting position with eyepads and ice packs for 1 hour. You will then be able to go home. You can expect minor ooze from wounds for 24 hours and significant bruising and swelling for around 2 weeks. We encourage ice packs 30 minutes at least 4 times a day and to minimise exertion.

How long am I in hospital after Blepharoplasty?

This procedure is a day procedure. If required you can stay in hospital overnight.

What post op care is involved after Blepharoplasty?

You will be seen at the one week mark for suture removal and wound check if this is required. You will then be seen at the 2-3 month mark as it may take this long for the eyelid to completely recover. Dr Slattery or the staff at Western Eyecare are available any time however should you have any queries or concerns.

When can I return to normal activities after Blepharoplasty?

Your vision will be blurry for around 2 weeks because of a transient change in refraction, dryness and dispersion of ointment used. Regardless, you should be able to drive and use a computer the day after surgery. Pain generally is not an issue, but you can take Paracetamol or Ibuprofen if required.

Eyelid Malposition - Both horizontal laxity of the eyelid combined with weakening of muscles that stabalise the eyelid margin contribute to Ectropion or Entropion.

It is critical to address both when repairing this problem. Other factors such as scarring of skin or conjunctiva can also contribute to eyelid malposition and will also need to be corrected.

Ectropion - The eyelid turns outward.

This generally causes symptoms such as watering or irritation. At times inflammation of the exposed conjunctiva can lead to gritty sensation, ulceration, mucous discharge and in worst case exposure of the cornea with corneal ulceration, scarring and visual comprimise.

Entropion - Inturning of the eyelid.

This is often very symptomatic with ocular irritation which may be intermittent at first but often becomes permanent. It is critical to correct this condition as corneal ulceration can easily lead to severe sight threatening consequences.

FAQ's

How is the Eyelild Malposition corrected?

On occasions, an offending inflammatory process or eyedrop may be contributing to the eyelid malposition and treatment may restore the lid position. Most of the time a procedure correcting excess laxity of eyelid tendons, and strengthening of lengthened stabalising muscles of the eyelid need to be performed. This may be combined with a full thickness skin graft or mucosal graft if there is insufficient skin or conjunctiva to allow the restoration of eyelid position.

How long am I in hospital after Eyelid Malposition surgery?

This procedure is usually day surgery. If the procedure has been combined with a skin or mucosal graft then an eye pad is usually required to stay on the eye at least 3 days.

What happens after the Eyelid Malposition procedure?

You will require ice packs for 1 hour over the affected eye. We recommend ice packs 30 minutes 4 times per day for the first week, but only twice per day if a graft is used. This procedure can lead to discomfort and a sandy feeling in the eye for up to one week. There may be minor discharge and blurring of vision which often resolves after a week or so. Bruising and swelling around the eye is to be expected and can be quite significant. Tenderness at the outer part of the eye associated with a lump is also to be expected and is intended.

When can I return to normal activities after Eyelid Malposition surgery?

For those who are not required to wear a pad, most activities can be continued the next day if comfortable. If you want to have a shower try to stay out of direct water flow and use some antibiotic ointment to the wounds prior. If you have a pressure pad then try to keep dry until removal.

Ptosis, 'Drooping Eyelids' - Drooping of the upper eyelid may be congenital or acquired and maybe uni- or bilateral. This can lead to impairment of peripheral (particularly superior) field of vision or be of cosmetic concern.

As well, patients have difficulty reading, especially at night, and may complain of a brow ache toward the end of the day due to compensatory overaction from the forehead muscles keeping the eye open.

Congenital: Children may be born with a 'droopy' eyelid.

This is often only a cosmetic concern but in a minority the lid can contribute to amblyopia (a weak eye). Your doctor may attempt to treat this initially with patching or drops to penalise the opposite eye if the droop is only mild however if severe, this may need to be corrected at an early age to prevent long lasting poor vision from visual deprivation. The droopy lid is otherwise generally more of a cosmetic concern and although can be corrected at any age, is often reserved until prior to school.

Congenital ptosis can be repaired by a number of mechanisms depending on the age and severity. The two main methods are either shortening of the muscle that lifts the eyelid (levator muscle) or a frontalis sling whereby the lid is connected to the brow via a sling and the eyebrow is used as an accessory to lift the eyelid.

Acquired: This generally is related to age, trauma or prolonged contact lens wear.

There is a dehiscence of the attachment of the levator muscle (muscle that lifts the eyelid) to the eyelid. This is often associated with multiple eyelid creases and excess upper lid skin. Treatment involves shortening the levator muscle and reattaching it to the lid in the appropriate position.

FAQ's

How is the Ptosis procedure performed?

Levator based surgery can be performed via a discreet incision in the upper lid crease or via the posterior eyelid in which there is no visible scar. Regardless of which approach, the muscle is shortened and reattached to the eyelid essentially raising the baseline position of the eyelid.

A sling procedure is performed also through inconspicuous incisions in the eyelid and forehead. Sling material may be synthetic (often slilicone) or using fascia from the outer part of the leg. Each has its own pros and cons and will be discussed at the time of consultation.

When performed on children this is generally performed under general anaesthetic but in adolescents or adults is usually performed under local anaesthetic with sedation so that the eyelid height can be tailored appropriately. The procedure generally takes 30-40 minutes per eye.

What happens after the Ptosis procedure?

Wet eyepads and ice packs are applied for 1 hour immediately post operatively. You will need someone to pick you up and take you home. Pain is generally minimal and simple analgesia such as Paracetamol usually sufficient. Dry eye is a common problem for several weeks after the procedure and lubricating drops may be required in the short term, but are rarely required longer than this.

What are the risks of the Ptosis procedure?

Eyelid skin is very thin meaning significant swelling and bruising are common. This generally lasts 7-10 days. A mild ooze from the wound is not uncommon for a day or two. There is usually low grade swelling for longer but this is not noticeable to the observer. Asymmetry of eyelid height or contour may occur and can be corrected if necessary. Importantly, the eyelid can be lifted or dropped again if required. Infection is rare and often patients will be given antibiotics at the time of surgery. Dry eye is very common and usually subsides after a few weeks but lubricating drops are often helpful in the early period. Once the swelling settles down, lid function and blink will improve also.

How long am I in hospital with Ptosis surgery?

This is generally performed as a day procedure. Expect to spend half a day in hospital.

What post op care is involved with Ptosis surgery?

Ice 30 minutes four times a day to the closed eyelid. This is often therapeutic also. An antibiotic ointment applied to the wounds three times per day for 2 weeks. At the four week mark we ask that the wounds be massaged with either a vitamin E, Bio-oil or Rosehip oil for two months thereafter.

When can I return to normal activities after Ptosis surgery?

Often the next day. Pain is generally not an issue but most patients will have mild blurred vision for a few weeks because of the antibiotic ointment, swelling, dryness and a subtle change in refraction of the eye. As long as you are comfortable with that vision, most non-strenuous activities can be continued. Please refrain from any strenuous activities and swimming for 2 weeks.

Minimise direct contact of water on wounds in the shower for the first three days. From there on use ointment to the wounds prior to having a shower in addition to three times per day.

×

Tag » How To Qualify For Eyelid Surgery