Lid Lumps / Lesions, Facial Lumps / Lesions:
These can vary from simple eyelid cysts to rare cancerous lesions. Majority of these lesions can effectively be dealt with surgically as a minor out-patient procedure.
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Lid / Facial Tumours or Malignancies:
These are ‘serious’ lesions can vary from the non metastatic(non spreading) Basal Cell Carcinoma (BCC) to a fast spreading Sebaceous Gland Carcinoma.
BCC is the commonest type of skin malignancy. Eyelid/periocular tumours are best dealt with by surgery. The other skin malignancies like Squamous Cell Carcinoma, Malignant Melanoma, Sebaceous Gland Carcinoma are very rare.
Eyelid tumours are best dealt with by oculoplastic surgeons since they require specialised reconstruction techniques and maintenance of eye surface.
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Lid Position Abnormaities:
Trichiasis-lashes rubbing against eye
Entropion is turning in of an eyelid. Ectropion is turning out of the lower eyelid.
Entropion: Entropion (inversion of an eyelid) is caused by age-related tissue relaxation, postinfectious or posttraumatic change, or blepharospasm. Eyelashes rub against the eyeball and may lead to corneal ulceration and scarring. Symptoms can include foreign body sensation, tearing, and red eye. Diagnosis is clinical. Definitive treatment is surgery.
Ectropion: (eversion of the lower eyelid) is caused by age-related tissue relaxation, cranial nerve VII palsy, and posttraumatic or postsurgical changes.
Symptoms are tearing (due to poor drainage of tears through the nasolacrimal system, which may no longer contact the eyeball) and symptoms of dry eyes with superficial keratitis (see Corneal Disorders:
Keratoconjunctivitis Sicca), possibly due to inadequate blinking.
Diagnosis is clinical. Symptomatic treatment can include tear supplements and, at night, ocular lubricants; definitive treatment is surgery.
The majority of the facial palsy patients make a near complete recovery. Eye protection is the most important part of the management while waiting for the functions to recover. A small proportion of patients need protective eyelid procedures to prevent corneal ulceration with the risk of permanent reduction in vision.
Facial Palsy can also follow tumour resection surgery eg. acoustic neuroma, salivary gland tumours etc. Mr. Sampath runs a joint facial nerve clinic with ENT, Plastic and Neurology consultants for patients who are complex and need combined procedures.
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Ptosis – droopy eyelid
(Raises the upper eyelids) Ptosis is a condition in which the eyelid droops. It is caused by a weakness or separation of muscles deep within the eyelid. Ptosis does not involve excess skin or tissue in the eyelid (a condition called dermatochalasis).
It is usually a result of aging, but some people develop ptosis after eye surgery or an injury, and some children are born with the condition. A brief surgical procedure can eliminate the drooping. Many young patients with mild to moderate ptosis do not need surgery early in life.
Patients who are also suffering from excess skin may choose to undergo blepharoplasty at the same time as ptosis repair. Children with ptosis should be examined regularly to check for other vision problems including amblyopia (“lazy eye”), refractive errors and muscular diseases.
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(Raises eyebrows) Browlifts can revitalize drooping or lined foreheads, helping you to look less angry, sad or tired.Using either traditional or minimally invasive (endoscopic) methods, browlifts involve the removal or alteration of the muscles above the eyes to smooth lines and raise the eyebrows for a more youthful appearance.
The procedure is often combined with other operations such as blepharoplasty (eyelid surgery) and facelifts to improve the look of the eyes and other areas of the face.
While browlifts are typically performed on patients aged 40-60 to counteract the effects of ageing, anyone with lined or inelastic skin on the forehead – whether it’s caused by muscle activity or inherited conditions – are eligible.
The procedure is usually performed under local anaesthesia/sedation
Related to trauma(injury)
Congenital abnormalities (from birth)
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