A pterygium is a raised growth on the surface of the eye. This happens primarily because of sun damage or long-term irritation from dry, dusty conditions. Normally, a pterygium grows on the inner side of the pupil, on the white of the eye.

The primary symptom of a pterygium is a painless area of elevated white tissue on the inner or outer edge of the cornea. The best way to avoid getting a pterygium is to wear sunglasses when outdoors. Wrap-around type sunglasses with 100% U.V. protection work the best. If a pterygium gets in the way of your vision or causes constant irritation to your eye, you may want to have it removed.

Pterygium treatments include:
When a pterygium becomes red and irritated, eyedrops or ointments may be used to help reduce the inflammation. If the pterygium is large enough to threaten sight, grows or is unsightly, it can be removed surgically.

If Surgery Is Needed

Your eye will be numbed with drops and an injection. A device will be placed around your eye to keep you from blinking. The pterygium growth will then be peeled away from the eye and surgically removed. Generally, no stitches are required.

After your pterygium surgery

It's normal for patients to spend at least one full day resting with their head elevated while using ice packs to reduce swelling. You may have a dull headache or slight discomfort. You'll need to use eye drops or ointment for several weeks as your eye heals.

Risks and possible complications

As with any surgery, there are some risks to pterygium surgery, including infection. The most common complication is the regrowth of the pterygium.

What is Blepharitis?

Blepharitis is a common and persistent inflammation of the eyelids. This condition frequently occurs in people who have a tendency towards oily skin, dandruff, or dry eyes. Blepharitis can begin in early childhood, producing granulated eyelids, and continue throughout life as a chronic condition, or develop later in life.

Symptoms of Blepharitis:

• Symptoms include irritation, itching, and occasionally, a red eye.

Blepharitis treatments include:

Blepharitis is a condition that may not be cured, but can be controlled with a few simple daily measures:

• At least twice a day, wet a washcloth with comfortably warm water, wring
it out, and place over the closed eyelids for a minute. Rewet it as it
cools, two or three times. This will soften and loosen scales and debris.
More importantly, it helps liquefy the oily secretions from the eyelids'
oil glands that help prevent the development of a chalazion, an inflamed
lump in an eyelid oil gland.
• With your finger covered with a thin washcloth, cotton swab, or commercial lint-free pad, gently scrub the base of the lashes about 15 seconds per lid.
• If an antibiotic ointment has been prescribed, apply a dab at the base of
the lashes (usually at bedtime), using your fingertip or a cotton swab.
Simple, daily hygienic measures will minimize the following additional
medications that might be needed to control blepharitis and its symptoms:
• Artificial tears may be used to relieve symptoms of dry eye. (These are
eye drops that are available without a prescription.)
• Steroid eye drops may be used short-term to decrease inflammation.
• Antibiotic ointment or antibiotic pills may be used to decrease the
bacterial content of the eyelids.

Medications alone are not sufficient; the application of warmth and detailed cleansing of the lashes daily is the key to controlling blepharitis.

Ptosis (pronounced toe' sis), or drooping of the upper eyelid, may occur for several reasons such as: disease, injury, birth defect, previous eye surgery and age. In most cases, it is caused by either a weakness of the levator muscle (muscle that raises the lid), or a problem with the nerve that sends messages to the muscle.

Children born with ptosis may require surgical correction of the lid if it covers the pupil. In some cases, it may be associated with a crossed or misaligned eye (strabismus). Left untreated, ptosis may prevent vision from developing properly, resulting in amblyopia, or lazy eye.

Patients with ptosis often have difficult blinking, which may lead to irritation, infection and eyestrain. If a sudden and obvious lid droop is developed, an ophthalmologist should be consulted immediately.

Signs and Symptoms

The causes of ptosis are quite diverse. The symptoms are dependent on the underlying problem and may include:
· Drooping lid (may affect one or both eyes)
· Irritation
· Difficulty closing the eye completely
· Eye fatigue from straining to keep eye(s) open
· Children may tilt head backward in order to lift the lid
· Crossed or misaligned eye
· Double vision

Detection and Diagnosis

When examining a patient with a droopy lid, one of the first concerns is to determine the underlying cause. The doctor will measure the height of the eyelid, strength of the eyelid muscles, and evaluate eye movements and alignment. Children may require additional vision testing for amblyopia.

Treatment

Ptosis does not usually improve with time, and nearly always requires corrective surgery by an ophthalmologist specializing in plastic and reconstructive surgery. In most cases, surgery is performed to strengthen or tighten the levator muscle and lift the eyelid. If the levator muscle is especially weak, the lid and eyebrow may be lifted. Ptosis can usually be performed with local anesthesia except with young children.

What is Ectropion?

Ectropion is the outward turning of the lower eyelid. Stretching of the lower eyelid with age allows the eyelid to droop downward and turn outward. Eyelid burns or skin disease may also cause this problem. Ectropion can cause dryness of the eyes, excessive tearing, redness and sensitivity to light and wind.

How is Ectropion treated?

Surgery may restore the normal position of the eyelid, improving these symptoms.

What is Entropion?

Entropion is the inward turning of the lower eyelid. It most commonly occurs as a result of aging. lnfection and scarring inside the eyelid are other causes of entropion. When the eyelid turns inward, the eyelashes and skin rub against the eye, making it red, irritated and sensitive to light and wind.

How is Entropion treated?

If entropion is not treated, an ulcerous infection may develop on the clear surface of the eye called the cornea.

With surgery, the eyelid can be turned outward to its normal position, protecting the eye and improving these symptoms.

Eyelid plastic surgery

Eyelid plastic surgery is almost always performed on an outpatient basis using local anesthesia. Before surgery, your ophthalmologist will perform an eye examination and make recommendations. Photographs and visual field testing are often required by insurance companies before blepharoplasty and ptosis surgery.

Under Construction

Corneal lesions amenable to treatment by superficial keratectomy include indolent ulcers, corneal neoplasms, dermoids, sequestrums, foreign bodies, corneal abscesses, bacterial and fungal keratitis (usually in conjunction with a conjunctival flap) and crystalline corneal degeneration. Prior to performing a superficial keratectomy, determining the depth of the lesion by careful biomicroscopy will help plan the surgery. If the resulting corneal wound extends from 1/2 to 3/4 thickness of the cornea, use of a conjunctival pedicle flap is warranted to provide protection of the cornea, help prevent perforation, and promote healing. Because corneal stromal tissue may not completely regenerate, the number of superficial keratectomies that can be performed at the same site is limited to two or three, depending on the depth of tissue removed with each procedure.

Superficial keratectomy procedure involves removing the corneal epithelium and superficial stroma with a surgical blade. The use of magnification (e.g., an operating microscope) is essential to perform the surgery, and specialized surgical equipment, such as a micrometer diamond knife, corneal trephine, and a corneal dissector, greatly facilitates removal of corneal tissue and may improve the clinical outcome. The initial corneal incision should completely surround the lesion to be removed and can be made using the corneal trephine, diamond knife, or microsurgical blade. The initial incision can be round, square, or triangular. After the initial incision is made, the edge of the tissue to be removed is grasped by forceps, and a corneal dissector (e.g., Martinez corneal dissector, 64 Beaver microsurgical blade, iris spatula) is introduced and held parallel to the cornea. The dissector is used to separate the corneal lamella without penetrating deeper than the original incision. The cornea is separated until the opposite incision line, or limbus, is reached. Scissors may be needed to connect the dissection to the opposite incision or to remove the corneal tissue from the limbus.

Following keratectomy, the cornea is treated with topical broad spectrum antibiotics to prevent infection, and topical atropine to decrease ciliary spasm and discomfort. A potentially devastating complication after keratectomy is corneal perforation, which is generally caused by infection of the surgical site. The potential for infection is exacerbated by deep, extensive keratectomies and is largely preventable by use of conjunctival flaps. Frequent reevaluations after surgery (with monitoring of healing by use of fluorescein dye application), use of topical antibiotics, and placement of conjunctival pedicle flaps in deep keratectomies should prevent most complications after surgery.

What is Chalazion?

The term chalazion comes from a Greek word meaning a small lump. It refers to a swelling in the eyelid caused by inflammation of one of the small oil-producing glands (meibomian glands) located in the upper and lower eyelids.

A chalazion is sometimes confused with a stye, which also appears as a lump in the eyelid. A stye is an infection of a lash follicle that forms a red, sore lump near the edge of the eyelid.

A chalazion is an inflammatory reaction to trapped oil secretions. It is not caused by bacteria, although the site can become infected by bacteria.

Chalazions tend to occur farther from the edge of the eyelid than styes and tend to "point" toward the inside of the eyelid.

Sometimes a chalazion can cause the entire eyelid to swell suddenly, but usually there is a definite tender point.

Chalazion treatments include:

When a chalazion is small and without symptoms, it may disappear on its own. If the chalazion is large, it may cause blurred vision.

Chalazions are treated with any or a combination of the following methods:

• Warm compresses:
Warm compresses can be applied in a variety of ways. The simplest way is to hold a clean washcloth, soaked in hot water, against the closed lid. Do this for five to ten minutes, three or four times a day. Repeatedly soak the washcloth in hot water to maintain adequate heat. The majority of chalazions will disappear within a few weeks. Sometimes antibiotic ointments are used in combination with warm compresses.

• Steroid injections:
lnjections can be useful after soaks have been tried and a small lump remains.

• Surgical incision or excision:
Large chalazions which do not respond to other treatments can be surgically opened after the early inflammation is reduced.

Chalazions usually respond well to treatment, although some people are prone to recurrences. If a chalazion recurs in the same place, your ophthalmologist may suggest a biopsy to rule out more serious problems.