Ptosis is a condition characterized by the eyelid drooping over the eye. For some people, the drooping is barely noticeable. However, for other people, the drooping can obstruct their vision.
There are two primary ptosis surgery techniques doctors use. (Learn More) The type of ptosis a person has and the degree of drooping play a role in deciding which technique is the best option.
The general technique involves tightening the levator muscle. (Learn More) The sling technique involves using the frontalis muscle to lift the eyelid. (Learn More)
With the general technique, there are two approaches the surgeon may use, including an external approach and an internal approach.
The external approach is also referred to as levator advancement. When the person has a high upper eyelid crease and normal levator function, this is the most commonly used technique.
The procedure happens as follows:
- The surgeon cuts into the eyelid skin.
- They take the levator muscle attachment and reposition it so it is attached to the tarsus.
- Sutures are used to keep the new position of the levator muscle.
This helps to raise the eyelid, so the drooping is not as apparent. People are not put to sleep for this procedure, but they do get sedation to ensure comfort.
The internal approach is another technique the doctor might consider when a person has strong levator function. With this technique, the eyelid is turned inside out. The surgeon then shortens the eyelid muscles. This may include shortening either the Mueller’s muscle or the levator muscle, depending on which one is contributing to the drooping.
The surgeon usually focuses on the levator muscle when the person needs more of a lift for their eyelid. The Mueller’s muscle is targeted when only a subtle lift of the eyelid is necessary. For this procedure, the doctor will administer either sedation or general anesthesia.
The sling technique is also called frontalis sling fixation. This procedure may be considered when someone has poor muscle function and ptosis. This is typically seen with neurogenic ptosis, congenital ptosis, or myogenic ptosis.
For this surgery, the frontalis muscle and the upper eyelid are attached to each other. The point of attachment is just above the eyebrows. A small silicone rod is usually used to attach the two structures together. It goes below the skin and is passed through the eyelid
What is ectropion?
Ectropion is a term used for describing the turning out of the
lower eyelid and lashes.
Why does it occur?
The majority of ectropion are due to laxity of the tissues of the
eyelid as a result of the ageing process, and some are due to
eyelid skin disease and shortage.
The eyeball is exposed and can become uncomfortable and
sore. The lower lid is turning outwards, the tears produced in
the eye will not drain correctly; therefore watering of the eye
will occur. There is also a chance of damage to the surface of
Ectropion will need to be repaired surgically to relieve the
symptoms. Eye lubrication with artificial teardrops might be
necessary. The surgery to repair ectropion can be performed
under local anaesthetic. This will involve tightening of the
lower lid, which will correct the lid laxity. This is not a small
procedure and will take 45 minutes. If the tear ducts are
damaged as well, there is a chance that patient may have
persistent watery eyes for which they may require a second
operation to resolve it.
The type of surgery you have depends on the condition of the tissue surrounding your eyelid and on the cause of your ectropion:
- Ectropion caused by muscle and ligament relaxation due to aging. Your surgeon will likely remove a small part of your lower eyelid at the outer edge. When the lid is stitched back together, the tendons and muscles of the lid will be tightened, causing the lid to rest properly on the eye. This procedure is generally relatively simple.
- Ectropion caused by scar tissue from injury or previous surgery. Your surgeon might need to use a skin graft, taken from your upper eyelid or behind your ear, to help support the lower lid. If you have facial paralysis or significant scarring, you might need a second procedure to completely correct your ectropion.
- What is Entropion?
Entropion is a term used for describing the turning in of the lower eyelid.
Why does it occur?
The main cause of Entropion is due to the ageing process in which loose
skin, weak muscles and lower lid laxity occurs.
Some patients with Entropion will find this condition extremely
uncomfortable. When the eyelid turns inwards the lashes can rub
against the surface of the eye, causing pain and watering. The affected
eye may be red in appearance and in some cases can cause a drop in
Entropion will need to be repaired surgically, before the rubbing of the
eyelashes causes damage to the surface of the eye. Whilst waiting for
surgery you may be advised to use some skin friendly tape to hold the
lower lid down, consequently relieving the symptoms. Sometimes,
Botulinum toxin can be injected to the eyelid to prevent the eyelid turning
in. This is effective usually for 2-3 months.
The surgery to repair Entropion is usually performed under local
anaesthetic. This will involve tightening of the muscles to correct the
turning of the eyelid. This is not a small procedure and will take
approximately 45 minutes. There is a small chance of recurrence in