Lid Problems:

Common eyelid problems include:

  • Ptosis or drooping or eyelids
  • Entropion or inward turning of eyelashes and
  • Ectropion or outward turning of eyelashes

Ptosis or drooping or eyelids, can be congenital (since birth) or acquired later in life. Senile ptosis is relatively common and caused due to weakness of the muscle responsible for lifting up the eyelids (Levator Palpebrae Superioris- LPS). Treatment of this form is by tightening the muscle by a surgery called Levator Palpebrae Superioris Resection or LPSR.

Management of Congenital ptosis will vary depending on the severity of ptosis and age of the child. When the eyelid is covering the pupil (or the central portion of the eye), immediate correction is important for normal development of vision.

Entropion or inward turning of eyelashes, can be congenital (since birth) and acquired (develops later in life). The congenital form is less common and self limiting. Treatment is warranted when it causes changes that can cause visual problems. Acquired form is usually secondary to other findings in the eyes like shortening of the posterior lamella of the eyelid because of varying causes. Definitive treatment would include correcting the primary pathology. Senile form caused due to weakening of the lower eyelid retractors is treated by surgically tightening the muscle.

Ectropion or outward turning of eyelashes is commonly caused due to age related laxity of the lower eyelid. Other common causes include 7Th nerve or Bells Palsy (paralytic), mass lesion of the eyelid (mechanical) and shortening of skin as in burns, etc. (cicatricial). Treatment involves treating the underlying cause.