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HELP CENTER
Conditions and Procedures
Blepharoplasty (cosmetic eyelid surgery) can be both a functional and cosmetic surgical procedure intended to reshape the upper eyelid or lower eyelid by the removal or repositioning of excess tissue as well as by reinforcement of surrounding muscles and tendons.
There are a variety of conditions that can cause our eyelids to interfere with our vision. Most frequently the aging process is the culprit. Excess skin tissue and/or fat can cause our eyelids to droop or look puffy. Many times this drooping will actually hinder one's vision by causing interference with peripheral or side vision. Some people notice that they have to "raise their eyebrows" in order to see well. Most of the time this occurs bilaterally, or in both eyes. Individuals with this condition feel as though they always look tired.
There are also some injuries and diseases that affect the nerves that go to our eyelids causing them to not function correctly. This is frequently seen in just one eye and is referred to as ptosis (pronounced toe' sis). Sometimes the condition will correct itself as the disease process is aleviated, but in many cases the ptosis will remain.
Through a surgical procedure known as a Blepharoplasty or Blepharoptosis Repair (blepharo means eyelid and ptosis refers to the drooping), this condition may be remedied. Under local anesthesia the patient has the excess skin and/or fat pads surgically removed. A fine incision is made in the upper eyelid which follows one of the natural creases. Stitches are put in which are removed in 1-2 weeks. Although everyone heals a little bit differently, patients usually experience very little discomfort, but they do notice temporary swelling and bruising around the eyelids. Again, this is just part of the healing process and these conditions will go away. In some situations the puffiness is just in the area beneath the eyes. This can also cause an unwanted tired or 'older' look to the individual. Again, through a minor surgical procedure under local anesthetic, the cause of the puffiness can be removed. This procedure is usually perfomed through a delicate incision that is made under the eyelid so there is no visible evidence on the skin.
Diabetic Retinopathy (blood vessel damage to the retina due to diabetes) is retinopathy caused by complications of diabetes mellitus, which can eventually lead to blindness. It is an ocular manifestation of systemic disease which affects up to 80% of all patients who have had  diabetes for 10 years or more. Despite these intimidating statistics, research indicates that at least 90% of these new cases could be reduced if there was proper and vigilant treatment and monitoring of the eyes.
Diabetic Retinopathy causes the delicate blood vessels in the retina (back of eye) to weaken, enlarge and/or sometimes to burst, leaking blood into the eye. If this condition persists, loss of vision may occur.
A laser is used to inhibit the growth of new abnormal blood vessels and reduce the size of the vessels already abnormally enlarged on the retina. It can also be used on leaking blood vessels to seal them off.
Dry Eye (any condition of strain or irritation and/or tearing of the eye) is an eye disease caused by decreased tear production or increased tear film evaporation commonly found in humans and some animals.
The aging process changes the effectiveness of tears in their ability to lubricate the eyes. Moisture helps eyes see and focus more clearly. Dry eye is a tear deficiency that makes sight appear as though looking through a dirty window. Sometimes, the eyes seem more watery, but those tears lack the true lubricant to keep eyes moist.
Treatments include using artificial tears, an ointment at bedtime, the use of glasses with side shields to protect from wind and sometimes inserting a small plug into the duct at the corner of the eye to keep natural tears from draining. If unchecked, dry eye can lead to more serious problems of the eye.
Ectropian (drooping eyelid due to age) is a medical condition in which the lower eyelid turns outwards. The condition can be repaired surgically.
Ectropion is a turning of the lid margin outward and away from the eye. Excessive drying of the cornea and exposed eye results, causing irritation and tearing. The condition is generally caused by abnormal muscle tone of the orbicularis oculi muscle or by scarring. Treatment is surgical and directed to the specific cause.
Entropion (inward turning lid) is a medical condition in which the eyelids fold inward. It is very uncomfortable, as the eyelashes rub against the cornea constantly. Entropion is usually caused by genetic factors and may be congenital. Trachoma infection may cause scarring of the inner eyelid, which may cause Entropion.
In entropion, the lid margins are turned inward causing the eyelashes to rub against the eyeball producing tearing, discomfort and possible scratching of the cornea. This condition may be caused by excessive action of the orbicularis oculi muscle or by scarring and is treated surgically.
Glaucoma (elevated pressure in the eye) is a disease that affects the optic nerve and involves loss of retinal ganglion cells in a characteristic pattern. There are many different sub-types of glaucoma.
Primary open angle glaucoma is the most common form of this eye disease. It causes pressure to build up within the eye, which may cause damage to the optic nerve. The optic nerve is essential for transmitting vision to and from the brain. If glaucoma is not kept under control it can lead to blindness.
Beginning at age 35, patients should be tested for glaucoma each year. The procedures that check for glaucoma include: a slit lamp exam, eye pressure check and a visual field test (which checks peripheral vision).
 To the right is a photograph of an eye pressure check.
Many patients retain central vision while losing peripheral vision long before they notice any loss of sight. Glaucoma is more common in older people, black people, diabetics and may be genetic. Life long attention must be maintained to keep glaucoma under control.
The most common treatment is the use of eye drops. If the eye drops fail to control the pressure within the eye, a laser procedure known as trabeculoplasty is recommended. Controlling the pressure within the eye is of utmost concern for maintaining good vision.
Keratoconus (abnormal cone-like shape due to corneal weakness) is a degenerative disorder of the eye in which structural changes within the cornea cause it to thin and change to a more conical shape than its normal gradual curve. Can be repaired by various surgical treatments if contact lenses and glasses don’t work.
The condition known as keratoconus occurs when the curved, crystal clear cornea (the covering to our eye) takes on a bulging or cone-like shape. When this bulging occurs the cornea also gets thinner. These changes in the cornea seriously affect the vision by causing astigmatism (irregular curvature of the cornea) which results in very distorted vision. Although the cause is usually unknown, there seems to be a genetic connection. Most of the time this condition occurs bilaterally (or in both eyes), but one eye may be affected before the other one. Onset usually occurs between 20 and 29 years of age and will commonly worsen over a period of 15 to 20 years. Since keratoconus involves a thinning of the cornea (and therefore probably weakening it), any procedure that involves changes in the cornea will further intensify the degeneration of a cornea that is already compromised.
If diagnosed by your ophthalmologist early enough, the condition can often be treated with the use of contact lens. If in an advanced state, keratoconus may need to be treated by performing a cornea transplant to achieve better vision. This condition would prohibit laser vision correction.
Macular Degeneration (decrease of the central vision) is a medical condition which usually affects older adults and often results in difficulty in reading. In extreme cases it may result in a loss of vision in the center of the visual field (the macula) because of damage to the retina.
 Macular degeneration forms in the central retina (back of eye) and causes loss of central vision of the macula. It is a complicated disease and is not always treatable. This disease is usually caused by the aging process, which changes the back of the eye through degeneration of the macula.
Testing for macular degeneration includes the use of an Amsler grid that the patient looks at to see if the lines appear straight and fluorescein angiography (injection of a dye into the arm) that checks for irregularities in the retina.
An individual with macular degeneration might see the Amsler grid as shown on the left (rather than straight lines).
Macular degeneration can sometimes be treated with a laser procedure, the use of low vision aids and is helped, in some cases, with anitoxidant formula vitamins. In some cases, a new therapy called Rheo Therapy can improve some patients' vision.
Pingueculum (yellow discoloration in the white of the eye) is a common type of conjunctival degeneration in the eye, often associated with UV light and temperate climates.
A pinguecula is a small, benign, yellow-white mass of degenerated tissue. This mass may be located on either side of the cornea and may be present in both eyes. Pingeuculae do not threaten vision but can cause minor eye irration.
Pterygium (growth on the cornea) triangular shaped fleshy tissue that grows onto the cornea.
A pterygium (ter ij' ee um) is a wedge-shaped growth, probably the result of sun irritation. The abnormal tissue gradually grows over the cornea and may cause irritation, chronic redness, foreign-body sensation and sensitivity to light. The growth can be surgically removed but may recur. Both pingueculae and pterygia are caused by ultraviolet light damage.
Strabismus (imbalance of the muscles that move the eye) is a condition in which the eyes are not properly aligned with each other.
Strabismus is caused by the misalignment of the extraocular muscles. This condition prohibits normal movement of the eyes. As a result, a patient may complain of double vision (diplopia). Strabismus may also result when one or more muscles lose their elasticity from scarring.
Surgical repair or tightening of the damaged muscles may restore alignment. Trauma or other disease processes may cause strabismus as the result of complete or partial paralysis (palsy) of muscle function due to nerve damage.
Treatment in this case is generally directed to the primary disease. Strabismus may also result from a congenital weakness of one or more extraocular muscles. In this case, the normal, stronger member of a pair of muscles will tend to pull the eye in a direction away from the weak muscle. The tendency of the eyes to deviate in some cases is prevented by the brain's effort to fuse the images. The eyes may also deviate in an upward, downward, or other direction, depending on which pairs of extraocular muscles are mismatched in strength.
Treatment of congenital strabismus generally consists of prescription eyeglasses, patching one eye, and surgically tightening the weak muscles. This is usually done at an early age because delays can risk permanent loss of binocular vision and three-dimensional visual perception. Therefore, it is important that diagnosis and treatment occurs by ages 7 to 8. |
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