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  Blepharospasm

Blepharospasm is uncontrolled blinking and squeezing of the eyelids. This is due to involuntary contraction of the orbicularis oculi muscle that controls the eyelids. It may be associated with mouth, head and neck movements. Progression of the condition may interfere with vision and negatively alter the patient’s quality of life.

Signs/Symptoms

  • Uncontrolled blinking
  • Closure of eyelids
  • Light sensitivity
  • Decreased vision

Treatment

Treatment involves botulinum toxin injection (commonly known as Botox), a non- surgical cosmetic procedure and in severe cases, surgical removal of the orbicularis muscle.

  Blepharoptosis (Droopy Eyelids)

Blepharoptosis (droopiness) can affect the upper eyelid of one or both eyes as a result of aging, a congenital defect, muscle deformity or neurological disorder. The condition can occur in patients of all ages, but is most common in older patients and will likely continue to worsen with age.

Signs/Symptoms

  • Droopy eyelid

Treatment

Various surgical procedures are used depending on the cause of blepharoptosis. Patients may seek treatment for medical or cosmetic reasons. Severe drooping may obstruct vision or distort the appearance of the eyelid.

  Chalazion

A chalazion is a lump that develops along the eyelid because of a blocked oil gland. A large chalazion may obstruct vision.

Signs/Symptoms

  • Mass on the eyelid
  • Eyelid redness
  • Eyelid tenderness

Treatment

A chalazion may go away on its own. A warm water compress applied four times a day may promote healing. Eye drops may be prescribed. A chalazion resistant to conservative therapy may require surgery. Do not push or squeeze a chalazion.

  Ectropion

Ectropion is a "turning inside out" of the eyelid so the inner eyelid is exposed. Common causes include aging, sun damage, tumors, burns and the removal of too much skin during upper eyelid lift (blepharoplasty). If the condition is not treated, the cornea may become damaged by abrasions, ulcers or infections.

Signs/Symptoms

  • Eversion of the eyelid
  • Dryness
  • Redness
  • Tearing

Treatment

Surgery is necessary to restore the eyelid to its normal position.

  Entropion

Entropion is a "turning in" of the eyelid, which causes the eyelashes to rub against the cornea. Entropion usually occurs as a result of aging, but other causes include injury, eyelid spasm, congenital defect and various inflammatory conditions.

Signs/Symptoms

  • Inversion of the eyelid
  • Pain and irritation of the eye
  • Redness
  • Tearing

Treatment

Treatment involves surgery to restore the eyelid to its normal position.

  Excessive Eyelid Skin/Puffiness

The skin of the eyelid is thinner than the rest of the face so it is often the first to lose elasticity. Several factors such as aging, sun damage and smoking can cause the eyelids to droop and sag as the supporting tissues deteriorate. Puffiness may be caused by environmental factors such as allergies and can be temporary. Both can result in an older, more tired appearance.

Signs/Symptoms

  • Puffiness above/below the eyes
  • Droopiness of the eyelids
  • Tired appearance
  • Itching eyes

Treatment

Puffiness that is not severe may be helped by a cold water compress on the eyes or reducing the use of salt and artificial sweeteners. More severe or extensive sagging typically involves surgery to rejuvenate the eyelids.

  Facial Wrinkles

The gradual development of facial wrinkles is common with aging. Extended sun exposure and smoking can make wrinkles worse.

Signs/Symptoms

  • Fine and/or deep lines around the eyes, mouth and on the forehead

Treatment

Botulinum toxin injection, commonly known as Botox, and facial fillers help soften or eliminate less severe wrinkles.

  Tearing

Excessive tearing is known as epiphora. It can be caused by obstruction of the lacrimal (tearing) system, overproduction of tears and eyelid malposition.

Signs/Symptoms

  • Tears overflowing and running down the face
  • Irritation of skin around the eyes
  • Infection from stagnant tears
  • Blurred vision

Treatment

Treatment depends upon the underlying cause. Options include lubrication for dry eyes, surgery to eliminate the obstruction of the tear duct or to create a new tear duct or surgery to tighten the eyelid.

  Thyroid Eye Disease

Problems in the thyroid gland’s function may lead to changes in the eye and orbit (eye socket). The combination of thyroid dysfunction and eye changes is known as Graves’ disease or thyroid eye disease (TED). Typically the eye symptoms occur when thyroid hormone levels are too high but can occur when these levels are normal or below normal. It is characterized by swelling and inflammation of tissue within the orbit. This may elevate pressure behind the eye resulting in protrusion of the eye, double vision and possible damage the optic nerve. Patients may also have large openings to their eyes.

Signs/Symptoms

  • Protrusion of eye
  • Large opening to eyes
  • Sandy sensation
  • Dryness
  • Double vision
  • Pressure sensation
  • Decreased vision

Treatment

Treatment depends upon the severity of the disease. Artificial tears and ointment are used to treat dry eyes. Certain cases may require steroid therapy, surgery for eyelids or eye muscles, orbital decompression surgery or radiation.

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