Eyelid Retraction Repair
Eyelid retraction can affect the upper or the lower eyelid. Eyelid retraction occurs when the eyelid is pulled away from the eyeball, either too far up in the case of the upper eyelid or too far down in the case of the lower eyelid. Common causes of eyelid retraction include thyroid eye disease, trauma, or previous surgery to the eyelids.
Repair of the eyelid retraction depends on the cause and the degree of severity. Releasing the eyelid itself may correct the problem or sometimes placement of grafts into the eyelid may be necessary. The specific treatment is determined after a detailed consultation with Dr. Howard.
Some patients may experience some bruising, swelling, and mild pain following the procedure. Initially, the eyelids may feel tight. This usually resolves over the first few weeks. On average, by one week after surgery, approximately 70-80% of the swelling will have dissipated and after two weeks, close to 90% of the swelling will have dissipated. The remaining 10% will decrease over the next few weeks to perhaps a month.
The eyelids can occasionally assume unnatural or incorrect positions. When the eyelid turns out, it is called an “ectropion.” Ectropion can cause constant irritation resulting from the eye being too exposed. When the eyelid turns in, it is called an “entropion.” Entropion causes the eyelashes to rub on the cornea, creating great discomfort and the potential for infection and ulceration of the cornea. In both cases, the tears may not be able to find their way to the drains in the eyelid. Both of these problems can be corrected with simple surgical procedures.
Poorly Closing Upper Eyelid
The eyelids were designed to close completely. Tears which are resting along the lower eyelid need to be distributed to the eyeball to keep the eye healthy. When we blink, the upper eyelid dips down into a “tear reservoir” and distributes the tears onto the surface of the eyeball. There are times when the upper eyelid does not close properly and this process is inefficient. This can occur after a stroke, Bell’s palsy, surgery, or simply because of a weakness of the eyelid closure muscles.
To help the eyelid close better, Dr. Howard can implant a weight, usually made out of gold or platinum, into the eyelid. This procedure also helps to better maintain a healthy surface for the eye itself.
Your Surgical Experience
Your surgery will be performed in an outpatient setting, meaning, our patients are able to go home directly following their procedure accompanied by a driver. Patients are usually given mild sedation from IV medication in a vein in their arm. This will ensure that patients are comfortable. There is usually no need for general anesthesia or a breathing tube or breathing machine.
We do anticipate you being at the center for a few hours for the entire process. After checking in, you will speak with Dr. Howard and Malissa LaRoche PA-C prior to your procedure. After the procedure is performed, you will wake up from anesthesia and receive aftercare instructions.
After Your Procedure
Following the procedure, patients are observed for a short while before they are allowed to go home. The first two days following surgery should be spent relaxing with the head elevated and applying ice packs (we suggest frozen peas if you do not have an ice pack). You will apply ice to the area(s) 30 minutes on and 30 minutes off for the first 48 hours during awake hours and then 4 times daily until your recheck appointment. This will help keep swelling to a minimum.
You will be seen by Dr. Howard and/or Malissa LaRoche, PA-C 1-2 weeks following your procedure to ensure you are healing properly. There are several tiny stitches that are placed that will dissolve over the first 2-4 weeks. These procedures are usually covered by insurance.