Eyelid Diseases and Oculoplastic Surgery

All surgical interventions on the eyelids, tear ducts and structures around the eye comprise oculoplastic surgery. Oculoplastic surgeries can be performed for aesthetic and cosmetic purposes as well as to correct disorders or diseases around the eye.

Blepharoplasty

The condition referred to as blepharochalasis is the sagging of the upper or lower eyelid skin excess and subcutaneous fat tissue hernia. Upper or lower eyelid blepharoplasty is applied in its treatment. Depending on the patient’s needs and wishes, the surgery is planned specifically for each patient. The aim of the blepharoplasty procedure is to remove excess skin and fat tissue in accordance with the patient’s wishes and age without impairing the function of the eyelid.

Ptosis / Droopy Eyelid 

Ptosis can be described as the upper eyelid droop and not being able to open fully. In patients with ptosis, there is an anatomical or functional problem in the muscle that lifts the eyelid. The exact cause of eyelid drooping should be determined. Treatment varies depending on the cause of eyelid drooping. As a surgical treatment, the levator resection technique (shortening the muscle that lifts the upper eyelid) or the frontal suspension technique (attaching the eyelid to the forehead with stitches) can be applied.

Entropion / Eyelid Turning Inward

​ Entropion is the turning of eyelid inwards. Entropion causes eyelash to get in contact with the ocular surface. Due to constant contact, recurrent eye surface infections and decreased corneal transparency may cause decreased vision quality. First, the cause of entropion should be determined and the treatment method is decided.

Ectropion / Eyelid Turning Outward

​ Ectropion is the turning of eyelid outwards.  Outwards turning of eyelid edge  leaves the eye surface exposed. Prolonged ocular surface exposure may cause dry eyes, recurrent infections and decreased corneal transparency, which may cause decreased vision quality. First, the cause of ectropion should be determined and the treatment decision is made.

Eyelid Tumors

Many types of tumors, benign or malignant, can develop on and around the eyelid. Lesions that grow and spread rapidly to surrounding tissue, show color change, and have a wound appearance that does not heal are considered suspicious for tumors. The treatment of tumors is surgical, and the surgical plan varies according to the location, type, and size of the tumor tissue.

Eyelid Surgery Process

Before Surgery

• The patient’s expectations and needs are learned and a special plan is made for the patient, and the expectations after surgery are explained to the patient in detail.
• Unless your doctor tells you otherwise, you do not need to stop your daily medications
• You do not need to stay in the hospital
• Since eyelid surgeries are generally performed with local anesthesia, fasting is not required before surgery.

Surgery Day

• After the surgical area preparations, local anesthesia is administered.
• Although it varies according to the type of surgery, the average surgical duration is 30-40 minutes.
• The patient does not feel any pain during the surgery.

After Surgery

• Edema is expected around the eyelid after surgery. Cold water/ice dressing is recommended for 10 minutes every hour to reduce this condition.
• Edema around the eyelid usually lasts 3-4 days, but this period may vary from patient to patient.
• The stitches are removed in the first week after surgery. The stitch removal process takes 3-4 minutes and is a painless procedure.
• In order to prevent scarring after the stitch removal, the patient should use cream applied to the eyelid for 1 month and direct sunlight should be avoided.

Lacrimal Duct Obstruction

Tear secretion drains into the nose through channels located on the medial edge of the eyelids. Lacrimal ducts can be blocked congenitally or due to acquired reasons such as recurrent infections.

Congenital Lacrimal Duct Obstruction

The development of the lacrimal duct sometimes lags behind and is closed at birth and opens during delivery or after birth. The first symptoms are watery eyes, epiphora and recurrent infections that resistant to treatment. Since the possibility of the lacrimal duct opening on its own is high in the first year of life, only massaging the lacrimal system is recommended in treatment. If the blockage does not open with massage by the end of the age of 1, the lacrimal duct is opened with a procedure called nasolacrimal probing. In this procedure, only the lacrimal duct is intervened. The procedure is performed with short-term general anesthesia.

​ Before Surgery

• Since the tear duct opening procedure is performed under general anesthesia, the patient’s laboratory tests and general anesthesia examination are performed before surgery.

Day of Surgery

• After general anesthesia, the tear duct opening procedure is performed. This procedure does not involve any incision or stitching.
• The average surgery time is 5-10 minutes.

After Surgery

• No serious pain is expected after the surgical procedure.
• It is recommended to use antibiotic eye drops for 1 week.
• There is no need for hospitalization after the procedure.

Acquired Tear Duct Obstruction

Tear duct obstruction may develop due to recurrent infections or advancing age. The first symptoms are epiphora in a closed environment and during rest, and recurrent infections that resistant to treatment. It is confirmed with examination that the tear duct is blocked. The treatment for tear duct obstruction in adults is surgery. In the surgery called dacryocystorhinostomy, a silicone tube is placed between the tear ducts and the nasal cavity to provide new tear duct passage. When the healing process is complete, the placed silicone tube is removed approximately 6 months after the surgery.

​ Before Surgery

• Since the tear duct opening procedure (dacryocystorhinostomy) is performed with general anesthesia, the patient’s laboratory tests and general anesthesia examination are performed before the surgery.
• Information is obtained from the Ear-Nose-Throat department about whether there is a nasal disease that may cause obstruction.

Surgery Day

• After general anesthesia, the new tear duct passage is established and a silicone tube is placed.
• The average surgery time is 35-40 minutes.

After Surgery

• Treatment is started for pain that may occur after the surgical procedure.
• Antibiotic eye drops and oral antibiotic pills are recommended for 1 week.
• There is no need for hospitalization after the procedure.
• The silicone tube is removed 6 months after the surgery. This procedure is performed in an office environment and is a painless and short procedure.