What are Eyelid Disorders ?
Eyelid lumps and cysts. Low-grade recurrent eyelid infection is a common condition called blepharitis. Styes may form due to infection of the eyelash root. A lump called a meibomian cyst or chalazion is also common. These form in the oil glands of the eyelid resulting in a visible lump on the eyelid surface. These can become infected resulted in pain and swelling within the eyelid. Wart like growths called papilloma is also common seen as small lumps on the eyelid margin or eyelid skin. Rarely tumours can develop on the eyelid. Basal cell carcinoma (rodent ulcer) develops slowly as a pearly like lump. Eyelid position disorders. With increasing age the muscle tone
within the eyelid often becomes reduced. This leads to “eyelid laxity”. The eyelid position can become abnormal with the lower lid becoming turned in (entropion), or turned outwards (ectropion). Entropion. Results in discomfort due to the eyelashes rubbing against the cornea. Ectropion. Results in watering of the eye as the collecting duct for tears is turned away from the eye. The upper eyelid may become droopy, a condition called ptosis. Infants may be born with ptosis, (congenital ptosis). If ptosis develops suddenly later in life there are a number of causes due to nerve dysfunction and urgent medical assessment is necessary. The upper eyelid may become droopy with age (involutional ptosis), this occurs slowly.
How do Eyelid Disorders occur ?
Chronic eyelid infection is commonly due to excessive oil production by the lid margin glands (meibomitis). This is often associated with excessive oil production in the skin resulting in acne or rosacea. Chalazion / meibomian cyst result due to the same process. Papillomas are due to a virus which results in a benign lump. Entropion and ectropion result from age change in the lids supporting tissue. Chronic inflammation particularly trachoma can cause eyelid deformity. Basil cell carcinoma is likely to result from long term exposure to sunlight. This occurs in the older age group therefore exposed skin areas.
Treatment Involved for Eyelid Disorders
Blepharitis is a chronic condition which basically is not curable. However, regular cleaning of the lid margins with either weak shampoo solution (baby shampoo) or a bicarbonate solution (baking soda) is useful in controlling the condition. Acute inflammation requires antibiotic ointments and / or drops. Meibomian cysts may result spontaneously however, if persistent and unsightly or causing inflammation, they require surgery. The cyst is incised and curreted from the underside of the eyelid. It is relatively simple procedure as an outpatient. Basil cell carcinomas are usually excised and the lid may require reconstruction if large. Radiotherapy can also be used as an alternative. Treatment for positional disorders requires surgery. However entropion can be controlled in the short-term by placing some tape on the skin beneath the lower lid to hold the lid away. The procedures for surgery are generally done with local anaesthetic as a day case procedure. Infants with congenital ptosis must be assessed to insure that the eyelid does not cover the pupil of the eye which would damage visual development. This results in a lazy eye. This is unusual and surgery for most cases of congenital doses is delayed until the child is 7 to 8 years old. Sudden onset ptosis requires urgent neurological assessment; the treatment will be dependent on the cause. Involutional ptosis can be treated by surgery and this is often combined with removing excessive overhanging upper eyelid skin.
After Treatment for Eyelid Disorders
Minor discomfort is common after any of the eyelid procedures and there may be some bruising. No significant problems are generally anticipated.
If Eyelid Disorders are Left Untreated
Delayed treatment for basal cell carcinoma is serious as the rodent ulcer continues to spread often along the margin of the eyelid without visual change. Sudden onset ptosis has a number of causes which may be potentially serious and investigation should not be delayed.