- Ptosis (Droopy Upper Eyelids)
- Eyelid Retraction
- Eyelid Contour Deformities
- Facial Paralysis / Bell’s Palsy
Ptosis (Droopy Upper Eyelids)
Upper eyelid ptosis is a common condition. It is where one or both upper eyelids droop, giving the appearance that one or both eyes are smaller. It often interferes with vision and can cause a feeling of heaviness and tired eyes. Dr. Palu performs surgery to correct upper eyelid ptosis either from the back of the eyelid, called a mullerectomy (Putterman procedure) or a tarsectomy (Fasanella-Servat procedure), or through the skin of the upper eyelid, called levator advancement or resection. Ptosis repair may be combined with upper blepharoplasty and a brow lift to enhance the appearance around the eyes. Dr. Palu performs ptosis correction surgery as an outpatient under local or sedation anesthesia.
Upper eyelid retraction is where the upper eyelid is pulled upward, exposing the upper part of the eye. More white of the eye may be seen. This gives the appearance of a “stare”. This exposure of the eye can cause redness, discomfort and tearing. Upper eyelid retraction is usually due to scarring of the eyelid skin or of the inner layers of the eyelid. It is seen in conditions where the eyelid has sustained inflammation or trauma and in thyroid disease when it affects the eyelids. Treatment is upper eyelid surgery to restore the eyelid to an appropriate position. Most often this involves surgery directed at the tissue causing the pulling up of the eyelid. This usually is done by releasing the scarred tissue through an incision in the crease of the upper eyelid. Dr. Palu performs surgery to repair upper eyelid retraction as an outpatient under local or sedation anesthesia.
Eyelid Contour Deformities
Irregularities in upper eyelid contour create asymmetry of the eyelids. It may be the result of trauma or surgery. Dr. Palu performs surgery to repair upper eyelid contour asymmetry as an outpatient under local or sedation anesthesia.
Facial Paralysis / Bell’s Palsy
Facial Paralysis and Bell’s Palsy result in an inability of the eyelids to close. There is incomplete protection of the eye and exposure of the eye. In the upper eyelid, this results in lagophthalmos, or incomplete downward movement of the upper eyelid. In the lower eyelid this results in a paralytic ectropion, the eyelid is turned out, down and away from the eye. These result in exposure of the eye. This can cause redness, discomfort and tearing. Treatment is directed at both the upper eyelid and the lower eyelid. It involves placing a gold weight in the upper eyelid to help the upper eyelid move downward during a blink and during closure. It also involves raising and tightening the lower eyelid surgery to restore the eyelid to an appropriate position. Most often this involves tightening a loose eyelid but it may require a skin graft or hard palate graft and/or canthoplasty.
Dr. Palu was among the first surgeons in New York to use gold weights in the treatment of ocular exposure due to facial paralysis during his work with neurosurgeons at NYU Medical Center over 20 years ago. He was also one of the first surgeons to use hard palate grafts for lower eyelid surgery. Dr. Palu performs gold weight and canthoplasty surgery for facial paralysis and Bell’s Palsy as an outpatient under local or sedation anesthesia.
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