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Common Eye Disorders
Eye Diseases
In addition to protecting your eyes from accidents, early detection and treatment of eye problems is the best way to keep your healthy vision throughout your life. By age 65, one in three Americans has some form of vision-impairing eye disease. Most do not know it because there are often no warning symptoms or they assume that poor sight is a natural part of growing older.
In many cases, blindness and vision loss are preventable. It is recommended to get yearly eye exams with dilation with your eye care provider.
Some Eye Disease Facts
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A family history of eye disease is one of the most common risks factors. Yet Americans with a family history of eye disease are not more likely to get screened regularly and do not have a greater knowledge of the risks. |
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Ethnicity is another important risk factor for eye disease, yet groups at high risk for glaucoma, such as African Americans, Hispanics and Asians, are not aware of their risk. |
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A third of Americans 65 and older do not get annual eye exams. |
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Ptosis
Symptoms
The most obvious sign of ptosis is the drooping lid itself. Ptosis can affect one or both eyelids. Congenital ptosis is present at birth. Acquired ptosis usually occurs as an adult.
Acquired
Adult-onset ptosis, acquired ptosis, is usually due to a stretching of the levator muscle. It may also represent a "pulling away" of the muscle from the edge of the eyelid where it normally inserts. This process may occur as a result of aging, after cataract surgery or other eye surgery, or as a result of an injury. This type of ptosis is usually repaired in same-day surgery through a small 1-2 cm incision in the central area of the eyelid crease. Sometimes a small tuck in the lifting muscle and eyelid can raise the lid sufficiently. More severe ptosis may require additional procedures.
Adult ptosis may also occur as a complication of other diseases involving the levator muscle or its nerve supply, such as neurological and muscular diseases and, in rare cases, tumors of the eye socket.
Congenital
Adult-onset ptosis, acquired ptosis, is usually due to a stretching of the levator muscle. It may also represent a "pulling away" of the muscle from the edge of the eyelid where it normally inserts. This process may occur as a result of aging, after cataract surgery or other eye surgery, or as a result of an injury. This type of ptosis is usually repaired in same-day surgery through a small 1-2 cm incision in the central area of the eyelid crease. Sometimes a small tuck in the lifting muscle and eyelid can raise the lid sufficiently. More severe ptosis may require additional procedures.
Adult ptosis may also occur as a complication of other diseases involving the levator muscle or its nerve supply, such as neurological and muscular diseases and, in rare cases, tumors of the eye socket.
Treatment
Your Eye M.D. may use blood tests, x-rays, or other tests to determine the cause of the ptosis and plan the best treatment. The most common treatment is surgery.
Your surgeon will evaluate the eyelid position and the excess skin to determine the contribution of each to the overall drooping of the eyelid. Most insurance companies do cover the procedure cost if there is enough drooping to block the pupil. The testing required includes a special type of visual field test to determine the amount of blockage from the skin or eyelid, and amount of correction achieved with the eyelid or skin held up. The goal of the surgery is to clear the field of vision once blocked by the skin or eye.
After The Surgery
Immediately after surgery, it may be difficult to completely close the eye. Lubricant eyedrops and ointment are helpful during this period. Depending on the degree of muscle function before surgery, some degree of incomplete closure of the eye may persist. This is usually well tolerated in children. Your surgeon may be able to predict this before surgery in some cases.
References: www.eyemdlink.com
Entropion Repair
An entropion is an inwardly turned (inverted) eyelid. The condition occurs primarily as a result of advancing age with consequent weakening of certain eyelid muscles. The imbalance between eyelid muscle groups results in the inward turning of the eyelid. This condition most often affects the lower eyelids, but may also affect the upper eyelids. Entropion repair may be completed with a variety of procedures. Most cases are completed with an incision in the outer corner of the eye to tighten the lower eyelid.
Most patients experience immediate resolution of the problem once surgery is completed with little if any post-operative discomfort. Most cases will require removal of sutures located along the lower eyelashes or the outer corner of the eyelid. Minor bruising or swelling may be expected and will likely resolve in seven to ten days following surgery.
A non-incisional entropion repair, known as a Quickert procedure, may be completed as an in-office procedure. This form of entropion repair requires two or three strategically placed sutures which will evert the eyelid. The procedure can be completed under local anesthesia with little if any discomfort.
The most important drawback of the Quickert procedure is that there is a significantly higher chance of recurrence of the entropion. However, it is an excellent procedure for patients who are not good candidates for procedures under anesthesia.
Ectropion Repair
An ectropion is an outwardly turned (everted) eyelid. The condition most often is associated with aging, though it may also occur congenitally, as a result of scarring or other surgeries, or secondary to facial nerve paralysis (Bell's palsy). If not repaired, the condition may lead to thickening of the surface on the inside of the eyelid, inflammation, and cause danger to the health of the eye itself.
The best method of repair for an ectropion often depends on the underlying cause. Involutional ectropion is associated with aging. To repair this most surgeons elect to shorten and tighten the lower lid, thereby resolving the outwardly turned lid. This typically is completed with an incision of the skin at the outer corner of the eyelid. The surgeon then excises a small segment of the lower eyelid, and subsequently reconnects the eyelid to underlying tissues and the upper eyelid.
Usually only a few stitches are placed in the skin at the outer corner of the eyelid, and these are often removed 7 to 14 days later. There is typically almost immediate resolution of the condition. Most patients have little if any discomfort with the procedure. There may be mild bruising and swelling following the procedure. This should resolve within about 7 to 14 days.
Cicatricial ectropion occurs as a result of scarring and is most likely to follow another surgical procedure of the face or eyelids, especially excision of skin lesions such as skin cancers. This type of ectropion repair often requires skin grafting. The donor site for the skin graft is most often taken from the patient's upper eyelid or from behind the ear. The skin from these sites will most closely match that of the patient's lower eyelid skin. Both the donor site for the graft and the surgical site will usually heal nicely within two weeks following the surgery.
References: eyemdlink.com |
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