Symptoms:
Eye irritation, dryness, watering problems, gritty sensation, difficulty closing eyes, visible scars or distortion (ptosis, ectropion, entropion).
Diagnosis:
Assessment by an oculoplastic specialist to evaluate eyelid function, scarring, and tear drainage issues.
Treatment:
Scar revision surgery (e.g. Z-plasty), skin/mucous grafts, tear duct reconstruction (DCR), Botox/steroid/5-FU injections, laser therapy, topical treatments, fat/hyaluronate fillers.
Our clinic operates as a private surgery and is not affiliated with the NHS (National Health Service)
The eyelids protect your eyes and the tears lubricate the surface of your eyes bringing clear comfortable vision. It is essential that the eyelids open and close smoothly.
Any damage to your eyelids and tear ducts can lead to permanent scarring, eyelid distortion, or displacement, ptosis and watering eyes, even if you receive treatment immediately. Trauma can affect eyelid function, the eye, its muscles and the lacrimal tear duct drainage system.
These changes can affect your vision, eye comfort and protection as well as appearance, lowering your self-esteem and reducing your quality of life. Clinica London offers a full range of treatments that reduce the impact of eyelid trauma and its consequences, including scarring and help restore normality to the eyelid, ocular surface, tear drainage and your quality of life.
Expert treatments for eyelid trauma scarring range from surgery to non-invasive methods including topical treatments or injections. Your personalized treatment program depends on your individual needs and the severity of the scarring.
Trauma in this context means physical damage, such as a penetrating cut, severe graze, or as a result of a surgical procedure. Trauma that heals cleanly usually causes no further complications. In some cases, though, your eyelid won’t heal neatly. Uneven healing can leave you with scars, eyelid distortion, change in eyelid function, altered eyelid and periorbital appearance and ocular discomfort that impacts in extreme cases, your vision. This is what experts refer to as eyelid trauma and scarring. In eyelid trauma, there may also be a direct penetrating or blunt eye injury bringing further visual effect, discomfort and scarring. We restrict this text to eyelid trauma scarring and injuries to the tear duct drainage system.
The tear ducts normally drain the tears from the corner of the eye near the nose and may be torn in eyelid trauma, healing with a permanent scar which affects tear drainage function adversely.
Early on in eyelid trauma, it is not always easy to tell if your eye and tearduct has been injured and the extent of the eyelid and lacrimal system trauma. Swelling can conceal foreign objects in your eye that may cause further damage and subsequent scarring later down the line.
A small cut can become larger without the right treatment, especially as it’s impossible to keep your eyelids still. A bang to your eye can also impact the tear ducts and other structures around the eye. If you hurt your eye in any way, you should seek medical assistance immediately — even if it doesn’t appear serious at first glance.
The following symptoms are found in eyelid trauma scarring:
An eye oculoplastic specialist will examine your eyes and lacrimal system, and determine exactly what’s causing your symptoms.
Numerous causes of eyelid trauma can lead to scarring and its associated problems. An eyelid injury is a common cause, particularly where the eyelid has been cut or the nearby canaliculus (fine tear duct) is impacted. The right type of eyelid laceration repair procedure should minimize the risk of later scarring and watering eye symptoms. It is best to repair the tear duct at the initial repair.
Accidents, like falling off a mountain bike or when climbing, are a frequent cause of eyelid injuries. These are most common in younger people. Even household objects such as coat hooks, hangers, table edges, doorknobs, and kitchen knives can cause eyelid and tear duct trauma if they come in direct contact with the periorbital region.
Assault using knives, with knuckle dusters and heavy hand jewellery can cause eyelid and tear duct lacrimal trauma.
A sports-related eyelid wound may occur at any age. Flying tennis and squash balls, falls, and flailing limbs all create risks to the eyes. Sportspeople may not seek the right medical assistance if they’re mid-match, increasing the chances of scars developing.
In some cases, it may be better to wait one or two days to perform surgery on an eyelid and tear duct injury. Once the swelling has reduced from an impact, for example, it’s easier for an ophthalmic surgeon to accurately pinpoint and fix the issue, especially if the tear duct has been cut near the inner corner of the eye. Eyelid bruising caused from a ball in the face to a simple fall, can hide more complicated problems.
From eyelid surgery to specialist injections, there are several ways to address eyelid trauma scarring and associated complications that can include tearing of the tear ducts and lacrimal outflow system.
Your eye specialist may recommend eyelid scar revision surgery. These procedures focus on reducing the size and appearance of eyelid scarring and help restore the eyelid and lacrimal function. These types of treatments can also help restore proper function to the eyelids and tear drainage, greatly increasing the individual’s quality of life.
Eyelid scar tissue removal and scar revision reconstructive surgery e.g. Z Plasty, is recommended for intense scarring that’s possibly constricting your eyelid or the surrounding area. Your oculoplastic specialist may recommend this in cases of excessive or constrictive scar tissue, to improve both movement and appearance by restorative surgery. A scar may require a skin graft taken from in front or behind your ear to increase the eyelid movement where restricted. Mucous membrane may be required, taken from your mouth, palate or cheek, to help correct restricted movement and malposition caused from internal tethering.
Initial eyelid laceration repair is used to handle cuts or tears in the eyelid and involves delicate reconstructive procedures. Sometimes this can result in scar tissue that requires further reconstruction a few months later. The better the initial repair, the better the long term result and avoidance of later scar complications.
There are also plenty of non-surgical options used for eyelid scar management. Botox is an injection based on the Botulism toxin and an innovative way to treat scars. The Botox injection helps minimise pressure caused by surrounding muscles while also inhibiting fibroblasts — the cells associated with generating scar tissue. Botox may be recommended by your eye specialist following treatment for eye trauma or other eye surgery procedures.
You may also be offered steroid injections. Corticosteroids can reduce the size and appearance of scars and encourage a smoother healing process after surgery. Antimetabolites such as 5 FU (5 fluorouracil) reduce scarring.
Laser therapy is another option for eyelid trauma scarring treatment. You may hear this type of light therapy referred to as skin resurfacing or laser scar revision. Laser treatments can prevent raised or unsightly scars from forming after surgery and may reduce the appearance of existing scars.
Your eye specialist may also recommend topical treatments. Some of these help by gently exfoliating the area to ensure new skin is revealed. Others encourage collagen growth or have a mild steroid. Some are simply to reduce irritation and inflammation while other treatments help reduce the appearance of eyelid scarring. You may also require antibiotics to prevent infection in this delicate area of your body.
Even skin grafting your fat into the eyelid or using hyaluronate gel can be used for deep sulcus deformity with hollow looking eyelid appearance.
The tear duct system may require excision of scar tissue and reconstruction, using special tear drainage operations based on DCR (dacryocystorhinostomy) if there is late scarring and watering of the eye.
Every eyelid repair treatment comes with specific aftercare and recovery steps. Always follow the advice of your ophthalmic surgeon as they’ll tailor these steps to your needs. In most cases, you won’t be able to drive while your eyes recover, and you may need to wear an eye bandage or other dressings.
As well as following your aftercare regimen, you can follow these steps to help accelerate your recovery:
The team at Clinica London will let you know what medications are appropriate. They may even prescribe you topical or oral treatments to help make your recovery more comfortable.
Don’t wear contact lenses until your eye has fully healed. These will irritate both your eye and your eyelid and could slow your recovery down significantly.
Keep your eye clean but don’t use strong chemicals as you’ll irritate the area. Avoid makeup and strong eye products such as eye-bag concealer until you’re fully healed. Your specialist should advise how long this will take and book you a follow-up appointment to ensure everything has healed as planned.
Always seek medical assistance whenever you hurt your eye — getting the right help fast can prevent excessive scarring later on. Once your eye is healing, if you notice any of the symptoms listed above, it could be time to see an eye specialist.
Gritty, irritated eyes aren’t always a sign of scarring. However, they do usually indicate an eye problem that needs attention before it gets worse.
Yes, unfortunately, any type of eyelid trauma can cause scars on the delicate skin here. Some people and races scar more than others. Treatments like eyelid scar revision surgery or certain injections can improve both the appearance and movement of your eyelids.
Recovery times vary by treatment and how complex your eyelid scarring is. Some procedures require only a short recovery time while others may need a few months. Usually count on three to six months for full recovery of function.
Eyelid scarring can stop you from blinking properly or keeping your eyes closed. In these instances, your vision may be impacted as your eyes become dried out.
Your eye specialist may recommend eyelid scar revision surgery or scar tissue removal and scar plasty, insertion of fat, mucosa or skin grafts. They may also suggest different types of laser therapy to improve the flexibility of the eyelid skin.
If you’ve experienced trauma to the eye, you should seek medical help immediately. Once home, keep the area clean and take any medications or apply ointments exactly as prescribed. Don’t put pressure on the affected area as you can cause swelling and bruising like this.
When you have eyelid trauma scarring treatments scheduled, make sure you don’t use any products like makeup or creams on the affected area. Try not to rub your eyes or press on your eyelids — you might cause swelling which can delay your procedure.
After any eyelid scar revision treatment, you’ll be given full instructions on how to care for your eye to maximize the recovery process. You’ll need to keep the area clean, avoiding harsh soaps and other products that could make irritation worse. You’ll also need to continue avoiding any pressure on the eye and any activities that could cause strain. Always follow your prescribed care regimen and take any medications you’ve been given.
If you’re concerned that you might have a problem from an eyelid scar or you have ocular discomfort or tearing as a result of an injury, accident or surgery, which is impacting your life contact us here at Clinica London.
At Clinica London, we have two Oculoplastic specialist surgeons, (also known as oculofacial plastic surgeons); Miss Michelle Ting and Miss Jane Olver. Their training and experience enable them to maintain and restore eyelid function and natural eye appearance through their delicate oculofacial plastic surgery skills.
Our clinic operates as a private surgery and is not affiliated with the NHS (National Health Service)
Getting the right treatment for myopia now could prevent serious eye problems later in your life. To find out more about the available treatments for myopia, book a consultation.
Telephone: 020 7935 7990
International Callers : +44 20 7935 7990
ENGLISH 
