Eyelids

 
 

Basal Cell Carcinoma and Tumour removal


Basal cell carcinomas are the most frequent type of malignant tumor to affect the eyelid, making up 85% to 95% of all malignant eyelid tumors. They are most commonly found on the inner portion of the lower eyelid, particularly in elderly, fair-skinned people. Prolonged exposure to sunlight seems to be a risk factor for developing this form of tumor.


There are many different kinds of basal cell carcinomas, but the nodular variety is one of the most common. It appears as a raised, firm, pearly nodule with tiny, dilated blood vessels. If the nodule is in the eyelash area, some lashes may be missing. The nodule may have some superficial ulceration and crusting and may resemble a chalazion or stye.


While these tumors are malignant, they rarely spread elsewhere in the body. For most of these tumors, surgery is the most effective treatment. In severe cases when the tumor has been neglected for a long time, it can spread into the eye socket, which may ultimately require removal of the eye and adjacent tissue.


Depending on the nature of your eyelid tumor, your ophthalmologist may suggest one of many possible procedures to remove the tumor, including normal surgical excision, microsurgery, or cryosurgery. You should discuss the various options and their advantages and disadvantages with your ophthalmologist.


Eyelid surgery to remove the tumor and repair the eyelid is usually an outpatient procedure performed under local anesthesia. Risks of surgery are rare, but asymmetry of the eyelids is one possible complication.


After eyelid surgery, bruising or a black eye is common, but it resolves quickly. It may be difficult for you to close your eyelid completely, making the eye feel dry. This irritation generally disappears as you heal. Serious complications are rare but can include vision loss, scarring, and infection.


   Ptosis


Ptosis is drooping of the upper eyelid. The eyelid may droop only slightly or it may cover the pupil entirely. In some cases, ptosis can restrict and even block normal vision.

Congenital ptosis, or ptosis that is present at birth, requires treatment in order for normal visual development to occur. Uncorrected congenital ptosis can cause amblyopia or “lazy eye,” which is an impaired visual development. If left untreated, amblyopia can lead to permanently poor vision.

Except in mild cases, the treatment for childhood ptosis is usually surgery to tighten the levator muscle, the muscle that lifts the eyelid. In severe ptosis when the levator muscle is extremely weak, the lid can be attached or suspended from under the eyebrow so the forehead muscles do the lifting. Whether they have had surgery or not, children with ptosis should be examined annually by an ophthalmologist for amblyopia, refractive disorders, and associated conditions.

Ptosis in adults is commonly caused by separation of the levator muscle from the eyelid as a result of aging, cataract or other eye surgery, an injury, or an eye tumor. Adult ptosis may also occur as a complication of other diseases such as diabetes that involve the levator muscle or its nerve supply.

If treatment is necessary, it is usually surgical. Sometimes a small tuck in the levator muscle and eyelid can raise the lid sufficiently. More severe ptosis requires reattachment and strengthening of the levator muscle.

The risks of ptosis surgery include infection, bleeding, and reduced vision, but these complications occur very infrequently. Although improvement of the lid height is usually achieved, the eyelids may not appear perfectly symmetrical. In rare cases, full eyelid movement does not return.