Dr S.S. Gill

Drooping Eyelid in Old Age

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about DERMATOCHALASIS.  

A common kind of droopy eyelid seen in old age is called dermatochalasis. If you look carefully, you will find that no one is really spared from this as they age. It does happen to almost everyone to a lesser or greater degree as they move onwards into their seventies and eighties. In dermatochalasis the eyelids appear to sag with excess “baggy” skin surrounding them that 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”) which is the general term for a droopy eyelid (discussed in the last issue).

Why does it happen?

In general, a person’s skin tends to sag with age, losing it’s’ 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 you blink your 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 does not help and hastens the process of eyelid sagging along with genetics, weight changes, and exposure to the sun.

Dr S.S. Gill
Upper pic shows what dermatochalasia will look like when compared to normal (lower pic) after blepharoplasty

Dr S.S. GillSymptoms

Apart from the cosmetic appearance of a person looking tired that results from dermatochalasis, 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.

Treatment

May be divided into SURGICAL and NON-SURGICAL. Surgical treatment is of course a more permanent solution to the problem.

Non-surgical options
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.

Over the counter Vitamin A skin creams have also been known to give some benefit but you do not have to spend an arm and a leg to get any of those super expensive creams having the same ingredients in them.

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,

Surgical option

This is the gold standard in the treatment of dermatochalasis. The surgery is called blepharoplasty.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah

(05-5455582) or email gilleyecentre@dr.com.