Reconstructive Oculoplastic Services
What Cancers Can Be Found on the Eyelids?
Several different kinds of skin cancer can develop on the eyelids. They are commonly referred to as eyelid cancer, and include basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma, sebaceous carcinoma, and melanoma.
Eyelid cancer may present as a painless, asymmetrical “sore” that may bleed at times. Eyelash loss may occur, and a notch may appear in the eyelid at the site of abnormal cell growth.
What Are the Types of Eyelid Malpositions?
There are four common types of eyelid malposition, all of which may attributed to some extent by aging. These include:
- Ptosis, which involves drooping of the upper eyelid.
- Eyelid retraction, in which the upper eyelid is too high and the lower eyelid is too low compared to the norm.
- Ectropion, which involves the outward turn of the lower eyelid.
- Entropion, which involves the inward turn of the eyelid, usually the lower one.
Eyelid malposition is not preventable but can be corrected with appropriate treatment.
Can You Live a Normal Life With Graves’ Disease?
Graves’ disease is an autoimmune condition that requires consistent follow-up with at least one specialist. The condition does not affect the eyes alone; it can affect the muscles, the heart, and even your behavior due to the impact on the brain. Due to the gravity of the consequences associated with unmanaged Graves’ Disease, it feels appropriate to questions whether you can live a normal life with this condition. The very fact that you need to maintain regular visits with your doctor may not seem “normal.” This depends on comparison. If we look only at living with Graves’, then we can say that, yes, you can live a normal life provided that you receive the consistent care that your condition demands. Today, we have more ways than ever to manage the ocular effects of Graves’ disease. These include medications and surgery as needed to manage symptoms.
What's the Goal of Orbital Reconstruction Surgery?
Orbital reconstruction surgery is one option for managing some of the effects of Graves’ Disease. It may also be necessary as a treatment for injury. The goal of any orbital reconstruction procedure is to restore the internal and external anatomy around the eye globe. This may involve repositioning or repairing injured or entrapped soft tissues.
How Are Orbital Tumors Diagnosed?
An orbital tumor is an abnormal growth in the area around the eye. Some are cancerous and some are benign. Examples of different types of orbital tumors include vascular lesions that form from blood vessels, cysts, neurogenic (nerve) tumors, and lymphomas. An orbital tumor may also be a secondary tumor that has metastasized from another area such as the cranium or sinuses.
A specialist will carefully examine the eye area to evaluate what may be an orbital tumor. Symptoms and medical history are also reviewed. Additionally, the doctor may order imaging such as CT scan, MRI, or ultrasound to observe the detailed aspects of the orbital area. A biopsy may be performed. However, an experienced specialist may discern the characteristics of a tumor using imaging and their physical examination alone.
What is Functional Blepharoplasty?
In general, blepharoplasty surgery is performed using the same techniques to achieve cosmetic goals as it is to achieve functional improvements. The primary difference between the two terms is that functional blepharoplasty is performed to address eyelid sagging that is causing some type of functional issue. For example, when there is redundant tissue on the upper eyelids, where functional blepharoplasty is performed, this tissue may fold over in a way that causes friction. This rubbing of the tissue can lead to persistent skin irritation. Another thing that functional blepharoplasty might improve is comfort. Many people who are living with significant upper eyelid hooding instinctively raise their eyebrows to create more comfort. The constant use of the muscles near the eyebrows can result in discomfort or even headaches. The most common reason we see patients for functional blepharoplasty is that their upper eyelids, one or both of them, are drooping down over the eyelashes or over the eye itself. This can cause discomfort and also visual impairment. Through functional blepharoplasty, the upper eyelid is lifted through precise trimming, removing the obstacle to good vision.
Does Functional Blepharoplasty Correct Eyelid Ptosis?
When a person seeks treatment for drooping eyelids, the term a doctor uses is "ptosis." This word is a general clinical way of describing eyelids that sag. Now, there are two reasons why eyelids might sag, and both may be referred to as ptosis. However, the type of treatment that is needed depends on what is causing the sagging to occur. Cosmetic and functional blepharoplasty work by removing excess eyelid tissue. Sometimes, ptosis originates in the muscle that raises the eyelid. This type of ptosis may be age-related or may be congenital or caused by an injury or tumor. When eyelid sagging is caused by a weak or injured levator muscle, the oculoplastic surgeon may perform what's referred to simply as ptosis repair surgery. In this, the levator muscle may be tightened or repositioned in a way that enables the eyelid to sit properly over the eye.
Will My Insurance Cover Blepharoplasty?
Blepharoplasty is typically deemed a cosmetic procedure. That said, there is sometimes a need for eyelid surgery. When blepharoplasty is performed due to vision obstruction or other physical or functional (not cosmetic) problems, it is referred to as functional blepharoplasty. In the case of functional blepharoplasty, the procedure to reduce redundant eyelid tissue may be covered by insurance. It may be necessary to meet certain pre-surgery requirements to obtain this coverage. Together, you and your doctor can determine if you may be a candidate for insurance-covered functional blepharoplasty.
Does Thyroid Eye Disease Always Require Surgery?
Thyroid eye disease, also called Graves' disease, can occur as a result of hyperthyroidism. It's a condition in which the immune system attacks the tissue around the eyes. The reason the eyes can be affected is that the cells in this area have the same protein that is also present in the thyroid cells. When the body makes antibodies against the protein, inflammation, swelling, and even scarring may occur. Having hyperthyroidism doesn't guarantee that Graves' disease will develop. Research suggests that about half of these cases eventually involve the eyes. Fortunately, there are numerous treatment options available if the tissue in and around the eye sockets becomes a target of the immune system.
Surgery for thyroid eye disease is called orbital decompression. It is performed when the effects of swelling and scarring behind the eyes is causing significant symptoms like bulging, pain, dryness, and double vision. Orbital decompression may reduce symptoms and also greatly improve your appearance. That said, doctors typically try to address thyroid eye disease using nonsurgical modalities before recommending surgery. Examples of conservative treatments include eye drops and ointments, medication, radiation, and prism glasses. Patients diagnosed with or who have a high risk for Graves' disease are strongly encouraged to work with an endocrinologist to manage hyperthyroidism. Also, smoking should be strictly avoided by people with thyroid eye disease.