A. PTOSIS - DROOPING OF UPPER LIDS

• Ptosis is a condition where there is drooping of the lid, though it is more common in the upper lid but can involve the lower lid too. It can which can be present in one or both eyes.

• Ptosis can either be present at birth (congenital), or may present later in life (acquired) usually as a result of stretching of the muscle over time. It may also occur with long-term contact lens wear, trauma, after cataract surgery or other eye operations. There are also less common causes of a droopy eyelid, such as problems with the nerves or muscles. 

Symptoms

• It can interfere with vision, by affecting the top part of the visual field

• It may be a cosmetic problem.

• Patients might have difficulty keeping their eyelids open, eyestrain or fatigue.

Treatment

• Ptosis can be corrected in most cases by a surgery which involves strengthening of the Lid muscles. It’s usually a Day Care procedure

• The surgery is done through an incision in the eyelid crease so the scar will not visible once healed. Any excess skin in the upper eyelid may also be removed at the same time. There will be some stitches along the upper eyelid fold which will be removed at one week.

• If both eyes have ptosis it is usually best to operate on both sides at the same time to give the best chance of a symmetrical result.

• In children with severe ptosis, surgical intervention needs to be done early to prevent Lazy eyes

​

B. LID RETRACTION - LARGE EYES

In contrast to ptosis, Lid retraction is a condition where the eyelid of the eye is retracted upwards and we have an appearance as if the patient is staring

Causes

• Thyroid eye disease

• Neurological causes like dorsal midbrain syndrome

• Endocrinal causes like Cushing’s syndrome

• Ptosis in the other eye

Treatment

• Botox injection

• Surgical Correction

• Treating the underlying systemic condition

​​

ENTROPION AND ECTROPION

Entropion

Entropion is a condition where the lid margin is turned inwards.

Causes: It can be caused by the aging changes in the muscles of the lid, following chronic infections or following an injury.

Symptoms: The eyelashes rub against the cornea and lead to watering, redness and sometime corneal ulceration and scarring.

Treatment : Surgical Correction

​

​

​

Ectropion

Ectropion is a condition where the lower eyelid is everted out

Causes: Age-related changes in the eyelid tissue, cranial nerve VII palsy, and post-traumatic or post-surgical changes.

Symptoms: Excess tearing due to poor drainage of tears through the naso-lacrimal system and symptoms of dry eyes.

Treatment: Medical management includes tear supplements and definitive treatment is surgery.