Ptosis (Droopy Eyelids)

Ptosis is drooping of the upper eyelids which can obstruct the peripheral vision. Ptosis repair surgery involves tightening of the muscle that lifts the eyelid. This may involve an incision in the eyelid crease. Ptosis repair is usually an outpatient procedure that does not require general anesthesia.

Eyebrow Ptosis (Droopy Eyebrows)

Drooping of the eyebrows may also cause obstruction of peripheral vision. There are several methods of repairing this condition. Brow ptosis repair is usually an outpatient procedure that does not require general anesthesia.

Ectropion (Turned out Eyelid)

Ectropion is the turning out of the eyelid. Ectropion may cause tearing because the tears are not properly distributed to the tear drainage system. Ectropion may also cause dry eye, because the eyelid is not appropriately apposed to the eye to spread the tears across the eye. The surgery is done through an incision in the outside corner of the eye. It may also involve the inside of the eyelid or the skin just below the eyelashes. Ectropion repair is usually an outpatient procedure that does not require general anesthesia.

Entropion (Turned in Eyelid)

Entropion refers to an eyelid that is turned in towards the eye. Often times, this causes the eyelashes to contact the front of the eye and irritate it. The surgery is done through an incision in the outside corner of the eye. It may also involve the inside of the eyelid or the skin just below the eyelashes. Entropion repair is usually an outpatient procedure that does not require general anesthesia.

Tear Duct Surgery

Excessive tearing may be the result of an obstructed tear duct. The surgery may sometimes involve a small incision in the skin between the eye and the nose, but in selected patients a non-incisional procedure may be used. During repair of the tear duct, a small silicone tube is often placed from the eyelids to the nose to keep the tear duct open after surgery. The patient is usually not aware of the tube, and it is usually removed several months after surgery. Tear duct surgery is usually an outpatient procedure, and it may or may not require general anesthesia.

Orbital Fractures

When a patient suffers trauma near the eye, one of the bones of the orbit (eye socket) that surrounds the eye may be fractured. Orbital fractures may cause the eye to sink in and may cause limitation of the motility of the eye. Both of these complications can cause double vision. Although some orbital fractures do not require repair, all orbital fractures should be evaluated by an orbital surgeon soon after the injury to determine if repair is indicated. Orbital fracture repair requires general anesthesia and may also require the patient to stay in the hospital overnight.

Thyroid Eye Disease – Orbital Decompression

Some patients with thyroid eye disease develop extreme swelling of the tissues around the eye. The muscles that move the eye may become swollen, causing double vision. Swelling around the eye may case the eye to bulge, making it difficult for the eyelids to close. This may lead to dry eye and discomfort. In severe cases, the swelling may also compromise blood flow to the optic nerve and cause a decrease in vision. Unless vision is compromised, it is important to postpone surgery until the patient’s eyes are stable for months.

Orbital decompression surgery involves making more room in the orbit (eye socket) for the eye so that its blood flow is not compromised and to reduce its bulging. Orbital decompression surgery requires general anesthesia, and may require the patient to stay in the hospital overnight. In patients who require orbital decompression surgery and other surgery for thyroid eye disease, orbital decompression is performed first.

Thyroid Eye Disease – Eyelid Retraction

Patients with thyroid disease may develop a wide-eyed appearance due to eyelid retraction. Eyelid retraction involves a widening of the space between the upper and lower eyelids. It may be due to an upper lid that is too high, or a lower lid that is too low. During upper eyelid retraction repair, an incision is made in the eyelid crease and the muscle that lifts the eyelid is relaxed. Sutures are placed in the incision and removed by your surgeon roughly one week after surgery. During lower lid retraction repair, the incision is made on the inside or outside of the lower lid, and the muscles that pull down the lower lid are weakened.Eyelid retraction repair is usually an outpatient procedure that does not require general anesthesia.

Thyroid Eye Disease –Strabismus Surgery

Patients with thyroid disease may develop strabismus, or misalignment of the eyes. For more information, please see the Strabismus section above.

Enucleation (Removal of an Eye)

Enucleation is a procedure that surgeons do not consider except in extreme circumstances. Occasionally, an eye needs to be removed because of a tumor in the eye, bad trauma to the eye, or extreme pain in a deformed, blind eye. During enucleation surgery, the eye is removed and an implant is placed underneath the conjunctiva (the membrane that lines the white part of the eye). Enucleation may require general anesthesia and may require the patient to stay in the hospital overnight.

About four to six weeks after surgery, the patient is able to be fitted with a prosthesis (a plastic shell that is custom painted to look like the other eye). The prosthesis never moves quite as well as the original eye, but it does move when the other eye does. Some patients elect to undergo an additional procedure six months after enucleation to further improve the movement of the prosthesis.

Facial Nerve Palsy

Facial nerve palsy may cause drooping of the eyebrow, poor closure of the eye, ectropion (turned out eyelid), and drooping of the mouth. Depending upon the individual patient, there are various procedures to correct these conditions.