Droopy vs. Saggy Eyelids: What is the Difference? Over time, many of us notice that our eyes look tired and sleepy. More importantly, we may even notice obstruction of our vision. More often than not, these are due to droopy and/or saggy eyelids. But, these two things are not the same; how are they different? Most patients who see their surgeon for droopy, saggy eyelids use these terms interchangeably. However, from a surgeon’s, pathophysiology, and therefore treatment standpoint, they describe completely different manifestations of the eyelids. In medical terminology, droopy eyelid is called blepharoptosis, and saggy eyelid is called dermatochalasis. Blepharoptosis means the edge of the eyelid, where eyelashes grow from, lays low on the eye. As a result, it covers the top portion of the eye and reduces the opening between the upper and lower eyelid. Because of these effects, the vision can be blocked or even altered due to induced astigmatism, an irregularity of the shape of the cornea. Many patients with blepharoptosis notice a shadow up top and/or to the side, difficulty with reading and even a headache across the eyebrows. The latter is due to over-use of the forehead muscles to lift the eyelids in order to compensate for the droopiness and improve vision. Dermatochalasis means excess skin of the eyelid that becomes redundant. When the redundancy progresses and worsens, the loose skin folds over the lashes and obstructs vision. Similarly to blepharoptosis, patients with dermatochalasis may notice a shadow and even a headache across the eyebrows for the same reason described above. In some cases, the folded skin may cause irritation. While blepharoptosis and dermatochalasis lead to similar effects (i.e., vision obstruction), the causes of these two conditions and the treatments vary. The causes of blepharoptosis include many, such as aging, neurological, mechanical, or muscular. Aging, or involution, is the most common cause of blepharoptosis. In our lifetime, over thousands of blinking and with gravity, the tendon of the levator muscle, that is responsible for lifting the eyelid, stretches, splits, or disinserts from its attachment. On the other hand, with dermatochalasis, the skin of they eyelid thins, loses its elasticity, stretches and eventually folds over the eyelashes. When the redundant skin hangs over the eyelashes, it makes the eye appear smaller when in fact the height of the opening of the eye is normal. Both of these problems are addressed with minimal invasive surgery. Blepharoptosis is repaired via tightening the muscle tendon, and dermatochalasis is repaired via removing the excess skin. They are typically performed as outpatient procedures at an ambulatory surgery center under sedation. Often times, these procedures may be performed in the office under local anesthesia. Following these minimal invasive procedures, patients may expect improved peripheral vision and more youthful appearing eyes.
Posted on: Wed, 20 Aug 2014 06:15:40 +0000
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