Our clinic performs plastic surgery for various changes and formations to the eyelids and the surrounding area for both cosmetic and therapeutic indications. All of these operations are performed for out-patients using local anaesthetics (injection), we use very fine non-traumatising stitching, which minimises the occurrence of scarring. In order to remove some of the smaller formations and eyelash epilation we use a modern electro coagulation instrument.

Commonest changes to the eyelid and surrounding areas

Blepharochalasis:
excess loose skin usually around the upper eyelids, which forms an overhanging vertical eyelash, sometimes reaching to the eyelashes.
- forms as the result of the skin around the eyelid weakening with age and the pressure from prolapsing periorbital fat
- during plastic surgery the excess loose skin is removed, followed by a part of the prolapsing fat tissue, after which we perform fine non-traumatic stitching with the thread inside the subcutis, thus minimising the risk of scarring

Xanthelasma:
yellow fat deposits in the skin, most commonly on the inner side of the upper eyelids
- during the operation the fat deposit is cut out and the skin carefully sewn back using fine non-traumatising material

Ectropion:
the edge of the eyelid (often the lower) turns outward. At the same time the lower punctum lacrimal is distorted, causing tears to form.
- most often occurs as a result of the eyelid tissue weakening with age
- resolved by plastic modification of the eyelid tissue

Entropion:
an infolding of the eyelid edge, the eyelashes are turned against the bulb and irritate the conjunctiva and cornea. This may be complicated by the development of a corneal ulcer.
- most commonly arises as a result of the eyelid tissue weakening with age, also as a consequence of various cicatricial processes.
- resolved by plastic modification of the eyelid tissue

Hordeolum (sty):
an infection of the small glands on the edges of the eyelids
- a careful excision is made and the cut cleaned from the inner side of the eyelid

Chalazion:
an inflammation of the larger glands on the edge of the eyelids
- a careful excision is made and the cut cleaned most frequently from the inner side of the eyelid

Trichiaza:
irregular growth of the eyelashes, which turn against the eye causing irritation
- resolved by epilation using electrocautery

Other formations on the eyelids and their surroundings:
All are treated by excision (for the smaller ones electrocoagulation), stitching and, if necessary, plastic treatment of the skin. Depending on the physician’s opinion the formations are sent for histological tests.

• Cutaneous horn:
  horny skin usually conical in shape
• Haemangioma:
  a red formation formed by a dense collection of small blood vessels
• Dermoids:
  congenital, round formations in the subcutis
• Papilloma:
  predominantly overhanging, stalked, hanging formations on the skin
• Lipomas:
  round formations in the subcutis formed by fat deposits
• Basalioma:
  most frequently a tumour on the eyelids, usually in old age
  - most usually a scaly or a pearly shiny raised formation, generally depressed in the middle, often bleeding of its own accord which dries to form a bloody crust
• Spinocellular epithelioma:
  a rare eyelid tumour
  - generally a hard knot with scales on the surface
• Malignant melanoma:
  a tumour formed by the skin’s pigment cells