By Dr S.S. Gill
Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about DROOPY EYELIDS IN OLD AGE.
DERMATOCHALASIS is a common kind of droopy eyelid seen in old age. No one is really spared from this as they age and becomes most noticeable as a person advances into their seventies and eighties. In dermatochalasis the eyelids appear to sag with excess “baggy” skin surrounding them which contributes to the typical droopy eyelid in old age. Dermatochalasis will almost definitely affect a person’s appearance, making a person look “sleepy”. Droopy eyelids are generally referred to as Ptosis (pronounced “toe-sis”) and this was discussed in the last issue.
Our skin naturally tends to sag with age losing its elasticity. Skin is made up of components called elastin and collagen. The COLLAGEN is a structural protein that functions by giving the skin turgor, support or form. The ELASTIN works by allowing the skin to stretch and contract to its original state. This stretching and contracting of eyelid skin occurs every time we blink our eyes. With aging there is an OVERALL LOSS IN AMOUNT AND QUALITY OF THIS COLLAGEN AND ELASTIN in the eyelids, making them sag or droop. GRAVITY of course hastens the process of eyelid sagging along with genetics, weight changes, and exposure to the sun.
Apart from the cosmetic appearance, a patient may complain of some visual difficulties. These visual difficulties may present as loss of vision in the upper part of the field of vision, reading difficulties and loss of peripheral vision when driving if the sagging eyelids overhang the side of the eyes. When the vision compromise occurs, the condition should be treated. Some patients compensate unconsciously by using the muscles of the eyebrows to lift the affected eyelids up. This effort may cause frequent headaches.
Maybe divided into SURGICAL and NON-SURGICAL. Surgical treatment is of course a more permanent solution to the problem.
The non-surgical options are of course great for patients who would like to address this problem but aren’t quite ready for surgery. Some of the common non-surgical options are:
The age old remedy of avoiding salty food, drinking plenty of water and getting enough sleep still holds good to this day. A good moisturizer may help in hydrating the eyelid skin to reduce the sagging effect.
BOTOX® injections can be injected into the eyebrows which will elevate them and therefore relax the eyebrow depressors, so that the unopposed muscles in the forehead will raise the position of the eyebrows.
This is the gold standard in the treatment of dermatochalasis. The surgery is called blepharoplasty.