Ectropion

Ectropion is the turning out of the eyelid (usually the lower eyelid) so that the inner surface is exposed. Ectropion is usually caused by the aging process and the weakening of the connective tissue of the eyelid. It can also be caused by other ailments such as long term conjunctivitis, watering, facial palsy etc.

Treatment

Artificial tears (a lubricant) may relieve dryness and keep the cornea lubricated. Surgery to tighten the muscles that hold the eyelids in place is usually effective. It may be performed as outpatient surgery with local anesthesia.

If you have ectropion, get medical attention if you experience the following emergency symptoms:

Decreasing vision
Pain
Light sensitivity
Rapidly increasing/long standing redness

Entropion

Entropion is a medical condition in which the eyelid (usually the lower lid) folds inward.Old age, Conjunctival Scarring from chemical, Thermal burns, long standing trachoma, acute membranous conjunctivitis can cause entropion. It is very uncomfortable, as the eyelashes rub against the cornea constantly.

Entropion may be caused by genetic factors and may be congenital.

Treatment

Treatment is a simple surgery in which excess skin of the outer lids are removed. Relieving the causative factor, tightening the muscle and fixing it over tarsal plate is the treatment of choice. Prognosis is excellent if surgery is performed before the cornea is damaged.

Ptosis

Ptosis is an abnormally low position (drooping) of the upper eyelid. The drooping may be worse after being awake longer, when the individual's muscles are tired. If severe enough and left untreated, the drooping eyelid can cause other conditions, such as amblyopia or astigmatism especially in children. This is why it is especially important for this disorder to be treated in children at a young age, before it can interfere with vision development.

Treatment

Levator resection
Müller muscle resection
Frontalis sling operation

Non-surgical modalities like the use of "crutch" glasses or special Scleral contact lenses to support the eyelid may also be used.Ptosis that is caused by a disease will improve if the disease is treated successfully.

Lid Injuries / Lid Tumours

Specialised surgical treatment for cut or lacerated lid injuries, and for lid tumours, biopsy, excision biopsy, total excision with lid grafting is done.

Squint

Strabismus, commonly called squint, is a condition in which the eyes are not looking in the same direction. It is the misalignment of the two eyes so that both the eyes are not looking in the same direction. This misalignment may be constant, being present throughout the day (constant squint), or it may appear sometimes and the rest of the time the eyes may be straight (intermittent squint).

It is a common condition among children. It may also occur in adults.

Paralysis of one or more muscles responsible for eye movement (paralytic squint). Sometimes a refractive error hypermetropia (long sightedness) not corrected by appropriate spectacle or non usage of spectacle may lead to inward deviation (convergent squint) of the eye (accommodative squint).

Poor vision in an eye because of some other eye disease like Cataract, uncorrected refractive error, corneal opacities, vitreous opacities, macular diseases, optic nerve disorders etc. may also cause the eye to deviate outwards (divergent squint). On one eye can be squinting (Unilateral squint) or both eyes can deviate alternately (Alternate squint).Therefore it is important in all the cases of squint, especially in children, to have a thorough eye check-up to rule out any other cause of loss of vision.

Problems with Squint

Normally the images from both eyes are superimposed in brain and we see only one image producing 3-Dimensional picture.. In children brain would ignore the image coming from the deviated eye because of poor quality of image from deviated eye, and thus sees only one image. And in the process, he loses the depth perception. This suppression of the image from the deviating eye results in poor development of vision in this eye, which is known as amblyopia which can unilateral or bilateral.

In case of paralytic squint, where vision is fully developed, brain cannot ignore the image from either eye, and therefore sees double vision (Diplopia). This can be very annoying and may interfere with work.

Symptoms of Squint

In a child, the parents may notice the deviation of eyes.

Adults may notice double vision, or misalignment of the eyes.

Check Up

The eyes are checked thoroughly to see for any refractive error, any defect in visual pathways such as Lid, cornea, lens, vitreous, retina, optic nerve that may be responsible for squint.

In younger children Examination under anesthesia (EUA) is undertaken.

Degree of squint, whether squint is unilateral or bilateral, whether paralytic or non-paralytic, is ascertained.

Next the eyes are checked for presence of amblyopia. It is important to treat the amblyopia before treating squint.

Squint Treatment

If there is any significant refractive error present, it is treated first. In some cases, a correction of refractive error is all that may be required to treat squint.

Treatment of Amblyopia (lazy eye)

This is the most important aspect in squint treatment. Treatment of amblyopic eye is started as early as possible as best results are obtained if treated before the 10 years of age. Occlusion by various modes depending upon age is practiced and parent`s cooperation is of utmost importance in curing the disease.

Once amblyopia is corrected the squint is treated by surgery of either one or both the eyes. We offer squint surgery, squint eye treatment and squint eye surgery for both eyes. Squint Eye Treatment and squint eye surgery involves weakening or strengthening of the relevant muscles to restore the balance and to get a good coordination. In some cases with double vision, prisms may be added in the glasses to ease the symptoms. Post-surgery exercises on machine may be required to attain Stereoscopic vision.

In a child, it should be started as soon as possible. The younger the age at which amblyopia is treated; the better is the chance of recovery of vision. A delay in treatment may decrease the chances of getting a good alignment and the vision. If amblyopia remains untreated squint may reappear even after successful squint surgery.