By Dr. Michael Grossman, Comprehensive Ophthalmologist, Illinois Retina & Eye Associates of Peoria
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| Michael Grossman, MD |
Do your eyelids seem to droop or people say you always look tired? Do your eyes feel heavy and take more effort to keep open? While droopy eyelids may be caused by a multitude of eye problems, some of which can be very serious and should be evaluated by an eye doctor, one of the most common causes is a condition called dermatochalasis.
Dermatochalasis is the medical term describing excess and lax eyelid skin. Due to this excessive skin and its loss of elasticity, the eyelid can appear to “droop.” This is a condition most commonly seen in elderly people, though it can also present at a much younger age as well. It affects men and women equally and there can sometimes be a genetic component.
As we age, the effects of gravity itself can affect the eyelid. The skin of the upper and sometimes the lower eyelid can lose its elastic properties and the underlying connective tissues can weaken.
Interesting Facts
Dermatochalasis can be a cosmetic issue but it can also cause functional vision problems — often it can 
cause both.
- Functionally: It can interfere with vision; dermatochalasis most commonly obstructs the upper visual field.
- Mechanically: The weight of the excess skin literally causes the eyelid to “fall” over the eye. As a result, patients may chronically and unconsciously elevate their brows to improve their field of vision. This constant use of the forehead muscles may frequently cause frontal headaches. Eye irritation, dry eyes, and inflammation of the surrounding eyelid skin may also be symptoms. The amount of skin can become so excessive that the eyelids are pushed inwards turning the eyelashes onto the surface of the eye.
- Cosmetically: Patients may notice a fullness or heaviness of the upper eyelids, which contribute to an aged appearance. Patients sometimes say that people always think they look tired, sleepy, or sad.
While your doctor can prescribe eye drops or eye ointment to reduce associated infection and dry eye problems, treatment of dermatochalasis usually involves surgery. Over 200,000 people undergo blepharoplasty eyelid surgery every year in the United States. Insurance often pays for the surgery if the eyelid skin blocks more than 20–25 percent of the visual field.
The procedure is usually performed in an office or outpatient setting under local anesthesia and generally takes about thirty to forty minutes. The excess skin of the eyelid is measured, marked, and excised and the new lid re-stitched together. Special care is taken not to remove too much skin, which can make it difficult to close the eye completely after the eyelids heal.
Following surgery, patients may have some swelling and bruising but this usually subsides within two weeks. In the majority of cases, patients see better after the surgery and have the added benefit of a rejuvenated appearance looking much younger, refreshed, and more “awake.”
Again, while dermatochalasis is a benign condition that in most cases is easily treatable, it is worth repeating that if you do notice your eyelid/s begin to droop — especially if it is a sudden, recent event — it can be a sign of serious conditions that should be evaluated promptly by an eye doctor.
If you would like more information on droopy eyelid surgery or would like to schedule an appointment, please call Dr. Michael Grossman at Illinois Retina & Eye Associates in Peoria at 309-589-1880.
Photo courtesy of Illinois Retina & Eye Associates