From time to time your eyelid may take on a life of its own, twitching at random. This involuntary quivering of the eyelid muscle usually lasts less than a minute, but it can drive you crazy and make you wonder if something's wrong with your eyes.
 |
| Eye Vision Problems |
A twitch is usually harmless. You may be able to relieve the twitching by gently massaging the affected eyelid. The cause of the twitching is unknown, but the condition is often associated with fatigue and stress. Rarely a twitching eyelid is a symptom of a muscle or nerve disease, but the twitching is usually accompanied by other symptoms.
Entropion
With entropion the eyelid - usually the lower lid - turns in toward the eye, allowing the skin of the eyelid and the eyelashes to rub against the conjunctiva. In addition to eye irritation, entropion can cause excessive tearing, discharge, crusting of the eyelid and a feeling that something is lodged in the eye. In severe cases the turned-in lashes may scratch the cornea, resulting in an infection or scarring of the cornea and impaired vision.
Most often entropion develops when the tissues of the eyelid relax as a result of aging. One of the first signs of the condition is irritation of the eyes in the morning, which usually clears later in the day. As the disorder advances, the irritation may become more frequent, even constant. You may notice the lashes turning in toward the eye, especially when you blink forcibly.
Treatment. Artificial tears or lubricating ointment can offer temporary relief for entropion by providing additional moisture. Some people wear a plastic eye shield at night to retain moisture.
The primary means of treating this condition is surgery to reposition the eyelid. The doctor does this by adjusting muscles or tendons of the eyelid. This is a fairly simple procedure that's usually performed on an outpatient basis using a local anesthetic. After surgery you may wear an eye patch overnight and use an antibiotic ointment for about a week.
Ectropion
Ectropion, like entropion involves the eyelid, usually the lower lid. But with ectropion the eyelid turns out, rather than in, and sags. The eyelid can no longer close properly, and without the protection of the lid, the inside of the eyelid and the surface of the eye become dry, irritated and inflamed. Normal tears flow out instead of lubricating the eye. Rubbing the eye can lead to encrusted eyelids and mucous discharge.
Ectropion is most often due to relaxation of the muscles and tendons in the eyelid as a result of aging. The condition can also be caused by scarred lid tissue from bums, trauma, tumors, a facial nerve disorder or previous eyelid surgery. Untreated ectropion can lead to infection, damage to the cornea from exposure and inadequate lubrication, and ultimately impaired vision.
Treatment. The treatment for ectropion is much the same as that for entropion. In addition some people tape the sagging lid in place at night to keep it from turning outward.
Dermatochalasis
As you age your eyelid skin gradually begins to stretch and sag. Fat gathers over and under the eyes. This age-related drooping of the skin in the upper or lower eyelid is called dermatochalasis (dur-muh-toe-KAL-uh-sis). In the upper eyelid, this condition may cause the eyelid skin to sag over your eyelashes and interfere with vision. The lower eyelid may form what is commonly known as bags under your eyes. Dermatochalasis usually affects both eyes.
Treatment. A surgical procedure called blepharoplasty (BLEF-uh-ro-plas-te) is commonly performed to remove excess skin, muscle and fat from the eyelid. It's generally a safe procedure and can be done on an outpatient basis. Blepharoplasty shouldn't interfere with your vision, and any swelling, tenderness or pain you experience afterward should subside in 2 to 4 weeks. Mild cases of dermatochalasis are sometimes treated with laser surgery. In this procedure skin and muscle are shrunk and tightened rather than removed.
Whether your insurer will pay for blepharoplasty depends on whether the drooping eyelid impairs your vision. Most insurers, including Medicare, don't cover surgery done strictly for cosmetic reasons but may pay if the sagging skin interferes with eyesight. To assist you, your doctor may conduct tests to document your vision impairment due to the drooping eyelid before surgery.
Ptosis
Less common and more complicated than dermatochalasis is a condition called ptosis (TOE-sis). It's caused by a weakness of the muscle that raises the upper eyelid and keeps it in an open position. Whereas dermatochalasis results in sagging eyelid skin, ptosis causes the entire lid to droop. Ptosis can affect one or both eyes and may partially block vision.
 |
| Eye Vision Problems |
Ptosis often runs in families. Some children are born with ptosis, usually in one eye only. In adults ptosis can be a result of aging or an injury. A condition affecting nerve and muscle response, such as myasthenia gravis, stroke, diabetes or a brain tumor, can also cause ptosis. A drooping eyelid that develops suddenly requires immediate attention. It may be a sign of stroke or another acute problem within your nervous system.
Treatment. If eyelid droop affects your vision, a thorough eye examination may be necessary to determine the cause. If the drooping is due to a nerve or muscle condition, treating this underlying cause may improve the ptosis. If the drooping is the result of aging or injury, your eye doctor may perform an operation to strengthen the muscle. This surgery may involve shortening the eyelid muscle and removing some of the overlying skin. It's a complicated operation that should be performed by a specialist in this type of surgery. To find out more, you can check out Eye Vision Problems.