Whether the problem is primarily cosmetic or sight related, Duke Eye Center offers the best medical and surgical therapies for a variety of conditions of the eyelids, eye sockets, and tear ducts, including droopiness (ptosis) of the eyelid, eyelid cancers, and tearing eye.

Cosmetic laser surgery to improve the appearance of the eye area is also offered.

Treatments

For those with lower-eyelid puffiness, dark circles, or drooping upper lids, Duke offers an outpatient surgical procedure called blepharoplasty. This procedure provides both cosmetic and functional improvement with minimal risk of serious problems.

Most patients can expect to look younger and often have an improved visual field. Results last for several years and can sometimes be permanent.

Ectropion (out-turning) and entropion (in-turning) of the eyelid can cause symptoms such as discomfort, tearing, mucus discharge, and reduced vision.

Ectropion may be treated with lubricating drops or ointments or with surgery.

Entropion is usually treated surgically. For elderly or other patients who may not be able to undergo surgery, sutures or injected medications may be used, although they tend not to be permanent.

In all cases of eyelid cancers, it is important that diagnosis and treatment happen as soon as possible. This prevents spread and allows removal and reconstruction of the eyelid with minimal functional cosmetic deformity. Complete excision is essential to prevent recurrence, which may be even more difficult to treat.

Surgery is the most appropriate method of removing tumors from the eyelids. A pathologist will then examine the specimen to ensure that the entire tumor was eliminated (Mohs technique).

Once the cancer is removed, the eyelid is reconstructed using a variety of different techniques which depend on the size and location of the defect.

Eye socket (orbit) conditions treated include:

• Thyroid orbitopathy
• Orbital trauma including wall and rim fractures and foreign bodies
• Orbital and optic nerve tumors
• Inflammatory or infectious processes such as abscesses, cellulites, and pseudo tumors

Additional conditions treated include:

• Eyelid retraction
• Benign lesions and inflammations
• Reconstruction to repair injuries, including eyelid and brow repairs
• Scar revisions
• Correction of lagophthalmos, trichiasis, and central angle repositioning

The Tear Ducts

Blockage of the tear-drainage system can be congenital or acquired later in life. Also known as tearing eye, the condition may resolve over several months with mild treatment such as massage and topical antibiotics. If infection occurs, surgery may be needed.

Procedures that may be used to treat blockage of the tear-drainage system include:

• Simple probing to clear blockages
• Silicone stent intubation
• Steroid gel infusion
• Punctal and canalicular reconstruction
• DCR surgery/Jones tube placement
• Lacrimal echography
• Endoscopic Holmium laser DCR
• Laser canalicular reconstruction

Physicians

Physicians offering this service include:

• Gandhi, Parag D.
• Richard, Michael J.
• Woodward, Julie Ann

Locations

This service is available at:

• Duke Eye Center
  2351 Erwin Road, Durham, NC 27710
• Duke Eye Center of Cary
  2000 Regency Parkway, Suite 100, Cary, NC 27518
• Duke Eye Center of Winston-Salem
  2025 Frontis Plaza Blvd, Suite 100, Winston-Salem, NC 27103