Eyelid Problems

Droopy Eyelids (Ptosis)

What is Ptosis?
Ptosis is the medical term for drooping of the upper eyelid. It can affect one or both upper eyelids and can sometimes be present at birth (congenital ptosis), but more commonly develops later in life.

What causes Ptosis?
The commonest cause of ptosis is aging of the lids. The muscle in the upper lid stretches with age and weakens, causing the lid to droop.
Rarely it can be caused by a neurological disorder such as Horner’s syndrome and myotonic dystrophy. Sometimes people who wear contact lenses or who have had surgery to their eyes or eyelids can also develop droopy upper lids.

When do you need surgery for Ptosis?
Most people who develop ptosis choose to have surgery to correct it because the appearance of the upper lid concerns them or the lids droops it interferes with their vision.

Surgery for Ptosis
Surgery to correct ptosis most commonly involves making a small incision in the upper lid and repairing the muscle that has become weakened. The surgery is usually performed under local anaesthetic with some sedation to try and achieve the best lid height at the end of the surgery.

Excess lid skin / Baggy eyelids (Dermatochalosis)

What is dermatochalasis?
Dermatochalasis is the medical term for excess skin on the upper or lower eyelids. It is often associated with an additional puffiness in the eyelid area due to some protrusion of fat from around the eye. The combination of excess skin and fat protrusion gives the appearance of puffiness and aging around the eyes that many patients dislike.

What can be done about it?
The excess skin and, if required, protrusion of fat can be removed surgically through a small incision in the upper lid skin crease or, for the lower lids via an incision just under the eyelash line.


What is blepharitis?
Blepharitis is a condition that causes soreness, redness and inflammation of the eyelid margins. It can start in early childhood or later in life and has a tendency to recur intermittently. For most patients it is bothersome but not serious. It can be associated with some skin conditions like Rosecea or Seborrheic dermatitis.

How do I know I have blepharitis?
Blepharitis usually causes the eyes to feel sore, itchy and generally uncomfortable. The area around the eyelashes may appear red and inflamed and you may be able to see small flakes of debris around the base of the eyelashes. The eyes may feel dry and sometimes the vision can be a little blurred because of the irritation.
Some patients find that their eyelids may be a little stuck together in the morning and need to bathe them to get them fully open.

How is blepharitis treated?
In most cases the symptoms will improve significantly with the following simple measures:

  • Cleaning the eyelids gently with a solution of cool boiled water with a little baby shampoo or sodium bicarbonate
  • Gentle lid massage with a warm hand towel
  • Applying antibiotic ointment to the eyelids
  • Using artificial tear drops

The lid cleaning should be continued on a long-term basis to prevent the symptoms returning
In more resistant cases a short course of oral antibiotics may be required.

Eyelid Tumors

What should I do if I have a lump on my eyelid?
If you develop a lump on your eyelid it is a good idea to get it checked by an Oculoplastic Specialist. Most lumps are benign (non cancerous) but some can be cancerous and need careful removal to make sure that they do not come back. The commonest type of skin cancer around the eye is called basocellular carcinoma.

Should I get the lump checked urgently?
If you have a lump around the eye that bleeds, is present for longer than a couple of weeks without getting better or is slowly getting larger then it is possible you could have a cancerous growth and you should get it checked as soon as possible.

How do you remove eyelid lumps?
The way of removing lid lumps depends on what the lump is. Sometimes it is necessary to biopsy the lump first in order to find out what it is.
The doctor will examine your lump and advise you as to the best course of action.

What happens if I have a cancerous lump?
If you have a lid lump that appears to be cancerous, the doctor will advise you on the best way to deal with it.
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