What will happen at my consultation?
In clinic I will assess your vision, examine your eyes, eye movements and eyelids. It can be helpful if you have old photographs (for example passport or driving licence). If ptosis is also detected, sometimes some further tests are occasionally required. We will then discuss the surgical options and benefits/risks of having the procedure carried out.
What happens during surgery?
I will discuss with you how much skin and additional eyelid tissue (usually fat) to remove. The incision for the surgery is almost always made in the skin in the existing eyelid crease. The skin incision is closed with sutures that are removed 1-2 weeks after the surgery. I take a photograph prior to the operation so that we will be able to compare the position of the lid after surgery.
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How long does the procedure take?
The operation takes about 20-35 minutes per eye.
What is the recovery like?
It is common you will experience bruising around the eye lasting for around a week and some bleeding that you can dab gently clean with tissue. You will be given drops and ointment to use and a clinic appointment will be made for a check up about a week later.
Can I go home the same day?
It is almost always a day case procedure, with no need for an overnight stay.
What is Ptosis?
Ptosis is the medical name for drooping of the upper lid, which can be present in one or both eyes. A low lying upper lid can interfere with vision and may also be a cosmetic problem. Patients might have difficulty keeping their eyelids open, cause eyestrain or eyebrow ache from increased effort needed to raise the eyelids and fatigue, especially when reading.
It most commonly occurs with aging, but can also be present from birth. It can be caused by long-term contact lens wear, trauma, eye surgery (including cataract surgery) and occasionally from neurological or muscle disease.
How is Ptosis treated?
The most common ptosis operation involves reattaching or shortening/tightening of the muscle that raises the lid. Local anaesthetic is required (and in some cases sedation, particularly for anxious patients). An incision is made into the skin in the existing eyelid crease where the muscle is found. It is reattached to the rigid tissue in the eyelid with sutures that either dissolve or remain under the skin surface. Ptosis surgery is often combined with removing excess skin in the upper eyelid (blepharoplasty). The skin incision is closed with further sutures that are removed 12 weeks after the surgery. This operation is a day case procedure, meaning you will be able to return home the following day.
You will be given a more detailed information sheet with guidance for the post-operative period, however you will usually need about one week off work and we recommend avoiding driving for a few days after the operation.
What is Ectropion?
Ectropion is the medical term used to describe the outward turning and laxity of the eyelid. This occurs quite commonly in the lower eyelid, but can occasionally affect the upper lid.
Ectropion can lead to excessive tearing, redness, mucous discharge, irritation of the eye or be cosmetically unsightly. Very occasionally severe Ectropion can cause permanent damage to the surface of the eye.
How is Ectropion treated?
Ectropion sometimes does not need treatment, but if patients decide they would like it corrected, surgery is required. Usually a small incision is made at the outer corner of the lower lid and the loose structures stretched and shortened, then resutured to the tissue overlying the bone at the outer corner. If there is a lack of skin in the lid (which more commonly occurs in people who have had greater lifetime sun exposure), a skin graft may be required. Possible donor sites include skin from the upper lid, behind the ear or over the collar bone. The surgery lasts between 30 to 60 minutes and is usually performed under local anaesthesia (numbing injections around the eyelid) with or without sedation. This operation is generally performed as a day case, meaning you are likely to go home the same day.
You will usually need about one week off work. The lower eyelid may feel tender, bruised and swollen for a couple of weeks after the surgery. If you have had a skin graft this may change to a darker colour; this is to be expected and will slowly improve with time. There may be some temporary numbness in the surrounding skin.