The goal of functional or reconstructive eyelid surgery is to improve abnormal function, reconstruct deformities, repair defects due to trauma or tumor-ablative surgery and in general to restore normalcy to the eyelid. Eyelid surgery may be performed for functional, reconstructive or cosmetic purposes.
Dermatochalasis is an aging change of the eyelids related to loss of tone in the various layers underlying the skin. It is a common finding seen in elderly persons and occasionally in young adults. The changes reflect the effects of gravity, loss of elastic tissue in the skin and weakening of the connective tissues of the eyelid.
Blepharochalasis is a condition separate and distinct from dermatochalasis. It is a rare disorder that typically affects the upper eyelids and is characterized by intermittent eyelid edema. It is unilateral in approximately 50% of the affected individuals and over time may result in relaxation and atrophy of the eyelid tissues.
Blepharoplasty is a surgical intervention to reduce the age-induced alterations in the tissues of the eyelids. Upper eyelid surgery for dermatochalasis is almost always cosmetic though, infrequently, it may be functional and correction may be necessary to treat refractory dermatochalasis and visual field obstruction from redundant upper lid tissues extending over the upper lid lashes. Lower eyelid surgery is always considered to be cosmetic.
Blepharoptosis is an abnormally low position of the upper eyelid margin, determined while the eye in primary gaze. As with many appearance related conditions, there is significant variation in the position of the upper eyelid in primary gaze. “Normal” upper eyelid position is considered to be approximately four millimeters, plus or minus several millimeters. Ptosis may be either congenital or acquired
Entropion is the inward rotation of the lower eyelid margin and lid support. It is almost always acquired and progressive. The etiology is likely a combination of factors and includes an attenuation of several tissue layers that stabilize lower lid function and laxity of the margin stabilizers.
Ectropion is outward rotation of the lower eyelid margin and lid support. As with entropion, the condition is almost always acquired, if progressive and has a similar multifactorial causation.
Brow ptosis refers to sagging tissue of the eyebrows and/or forehead. Brow ptosis is caused by aging changes in the forehead muscle and skin, which leads to weakening of these tissues and sagging eyebrows. Repair of brow ptosis is performed to tighten the muscular structures supporting the eyebrow. The surgery is performed through a supra-brow incision over the affected eye.