Unbridled Vision

Surgery can improve eyelid function

For movie stars and other celebrities, plastic surgery is practically mundane, but most of us only daydream about it in front of the mirror. However, not all lifts and tucks are cosmetic; some can actually (drastically) improve your vision. Welcome to the world of oculoplastic surgery and blepharoplasty.

Oculoplastic surgeons operate on the eye sockets, eyelids, tear ducts and face. They are ophthalmologists (eye surgeons) who complete one to two years of additional fellowship training following their ophthalmology residencies.

Blepharoplasty, simply defined, is a type of surgery that modifies the eyelid, so an oculoplastic surgeon would perform a blepharoplasty. While patients often seek blepharoplasty to improve their appearances (lower eyelid blepharoplasty, for instance, is almost always cosmetic), doctors frequently recommend it for functional reasons as well; this is referred to as functional blepharoplasty. Too much skin on the upper eyelid sometimes protrudes over the eyelashes and causes peripheral vision loss. Since the outer and upper visual fields are usually most affected, it can make driving or reading difficult. Fortunately, health insurance often covers functional blepharoplasty.

Excess skin on the upper eyelid is most commonly the result of advanced age, but this condition can also be caused by infection, degeneration, trauma, muscular or neurologic disease or a tumor.

Ptosis is the medical term for sagging of the upper eyelid, and it can affect one or both eyes. Ptosis in which the lid only partially covers the pupil is considered mild, whereas a drooping lid that completely covers the pupil is severe.

Dr. Bryan Vekovius, the only combined fellowship trained oculoplastic surgeon and neuro-ophthalmology specialists in the area, performs dozens of these types of surgeries every week. Neuroophthalmology relates to vision problems that originate from the nervous system. In addition to other conditions, he said, “We take care of people who have normal age-related changes to their eyelids. We also take care of patients who have too much skin [around their eyelids] and weakness in the muscle that controls the blinking – the weight of that or the bulkiness of the lid can cause the eyelid to droop.”

In the case of a patient who, for whatever reason, didn’t have any muscle function inside his or her eyelid, Vekovius would perform a type of blepharoplasty involving a “sling” procedure which connects the eyelid to the eyebrow to allow the muscles of the forehead to open the eye. In less severe cases, a levator advancement or resection can strengthen the muscle and allow it to open the eye more briskly and strongly.

Recovery from blepharoplasty, which is normally an outpatient surgery, is relatively easy, most of the time. Doctors often prescribe ointments or drops and sometimes painkillers to help with discomfort. Cold eye pads can also help. Patients can usually return to work and otherwise normal activity within a week.

This procedure not only has the potential to give a person a more youthful appearance, it can also provide a great gift – unobstructed sight – and the results can last a lifetime. For more information, contact Vekovius’s office at 675-3733.