Hooded eyelids, puffy eyelids, stretched eyelids are all terms used to describe dermatochalasis, which is an excess of soft tissue in the upper eyelids. It can be caused by age, congenital or from chronic swelling of the eyelids, which has stretched them and created an excess skin. Often the patient tries to compensate for the additional fold of skin by lifting their brows.
By lifting the fat tissue and excess skin off the eyelashes and out of the vision, they can see better. However, after a while raising the eyebrows gets quite tiring particularly in the afternoons and towards the end of the day, and then their eyelid skin drops back down like an awning over their vision. This awning or hooded eyelid has to be treated with surgery because it is causing a functional problem.
Some patients even use Sellotape to tape up their eyelids towards their eyebrows to see out better. Some patients push their eyelids upwards with their finger when reading to reading apparently. Some patients have glasses specially designed to try and push up the eyelid. But after a while none of these efforts is useful, and functional eyelid surgery is indicated.
Oculoplastic surgeons are well qualified to assess hooded eyelids and carry out functional eyelid surgery because of their deep understanding of the function of the eyelids, the relationship with the ear film and the surface of the eye, and the delicate anatomy.
If you are having a problem with your upper eyelids because they are hooded or you notice an awning over your vision, then you require assessment clinically by the consultant oculoplastic surgeon. The oculoplastic surgeon will observe the eyelids, will do specific eyelid measurements and take photographs. The technician or nurse will do the photos and also often does the visual fields, which is to show how much the upper eyelids interfere with vision if the patient has private medical insurance.
Although hooded eyelids are often thought of as being a cosmetic defect, often they cause a practical visual problem and should be dealt with as if a medical problem. You will be surprised how many patients say “I see better after my blepharoplasty surgery” or “it is like an awning lifted from my over my eyes”. Blepharoplasty opens up the top field of vision and can make a big difference to how much a person sees.