Sagging upper lids and baggy, swollen or inward- or outward-turning lower lids can impair peripheral vision (which can include upward, downward and side views) as well as cause discomfort, invite infection and make people look perpetually tired or haggard. Certain eyelid conditions may be inherited, but most often these problems develop with age as the skin becomes less elastic and vulnerable to the effects of time and gravity.
Board-certified Comprehensive Ophthalmologist, Shelby Terpstra, DO, is one of Central Florida’s most experienced and respected eyelid surgeons, and has performed thousands of procedures to correct drooping, sagging, baggy and inward/outward-turning eyelids, helping patients enjoy a wider field of vision, greater comfort and a more refreshed appearance.
During consultation, Dr. Terpstra examines the eyelids and manipulates them manually to assess a patient’s improvement in vision and/or appearance. Eyelid surgeries are customized to each patient and his or her problem(s), which may be one or more of the following:
Dermatochalasis – Excess Skin
The skin of the eyelids is especially fragile, and over time it can stretch and droop over the eye or collect in folds under it, cutting vision by as much as half. This is not only a nuisance, it can also be dangerous, as people can’t see what’s on the floor, overhead or off to the side, creating a risk of injury. Blepharoplasty is a surgery that reduces the amount of skin and excess fat in the upper and/or lower lids, creating better vision and a more rested, youthful look.
Ptosis – Drooping of Upper Eyelid
Often running in families, ptosis is a condition in which the upper lid drapes over the eye, reducing side and central vision and making people look tired or medicated. Without treatment, ptosis can lead to astigmatism (flattening of the eyeball) and amblyopia (so-called “lazy eye’), making it a medical problem in addition to a cosmetic one. “Correcting ptosis is a matter of reducing the slack in the muscle that lifts the eyelid,” says Dr. Terpstra. “It is a procedure that produces noticeable improvement in both field of vision and appearance.”
Entropion – Inward Turning of the Lower Lid
When the lower eyelid twists inward, it forces lower lashes and eyelid skin to rub against the eye, creating irritation, redness, excess tearing and discomfort, as well as a susceptibility to eye infections. Surgery can correct the position of the eyelid, providing improved function and comfort.
Ectropion – Outward Turning of the Lower Lid
A drooping, outward-tuning lower eyelid leaves the eye vulnerable to dryness, redness, excess tearing and infection, and makes it look irritated and unsightly. A quick surgical procedure can help normalize the lid, making eyes look and feel better quickly.
Eyelid surgery is quite safe and usually quick, with recovery ranging from a day or two to several weeks, depending on the procedure(s); bruising and swelling vary by patient and account for the bulk of recovery. Pain is usually minimal and relieved by over-the-counter medications like acetaminophen or ibuprofen. In cases where eyelid disorders significantly reduce one’s vision, corrective surgery may be covered by insurance.
“My patients report being able to do things that many thought they’d have to give up, like reading, driving and other activities requiring adequate peripheral vision,” says Dr. Terpsta. “They’re also delighted by how much more rested, relaxed and refreshed they look and feel. Seeing their happiness delights me, too.”