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Surgical Methods for Managing Dry Eye
While many cases of dry eye can be managed with non-surgical treatments, some patients require surgical interventions to achieve lasting relief. Surgical methods are often necessary when dry eye symptoms, such as excessive tearing, lack of tears over ocular surface resulting in chronic inflammation are as a result of underlying structural abnormalities with the eyelids or tear duct system.
Chalazion Surgical Drainage
A Chalazion is a small, non-infectious bump that forms on the upper or lower eyelid due to a blockage in the meibomian gland. When these glands become blocked, the trapped fluid can lead to the formation of a chalazion. In some cases, an eyelid infection can also cause a chalazion.
Chalazia often resolve on their own over several months. Home remedies include warm compresses and antibiotics to treat any underlying infection.
Surgical intervention with steroid injections and/or surgical drainage may be considered when chalazion persists, if patient is looking for rapid symptom relief or if there is visual impairment.
Steroid injections are considered when reducing inflammation and size of swelling. For persistent large chalazia, surgical draining is performed by the Surgeon under local anesthesia. This procedure involves a small incision to drain the contents of the chalazion, providing immediate relief from symptoms.
If a chalazion recurs in the same location, a tissue biopsy may be performed to rule out more serious conditions. Dr. Hess at North Toronto Eye Surgical Centre performs surgical Chalazion removal.
Eyelid Malposition Surgery
Eyelid malposition surgery addresses conditions such as entropion and ectropion. Entropion involves the inward rotation of the eyelid margin, causing the eyelashes to rub against the eye, while ectropion is the outward rotation of the eyelid margin. Both conditions can affect the upper and lower eyelids, leading to poor lid closure, incomplete blinks, and corneal exposure. This results in inadequate tear film distribution and chronic ocular surface irritation, significantly impacting quality of life with symptoms like blurred vision, excessive tearing, pain, and a foreign body sensation. Surgery is often necessary to correct these malpositions, improving symptoms of dry eye and ocular irritation.
Punctoplasty
Punctoplasty is a surgical procedure designed to treat punctal stenosis, a condition where the external opening of the tear duct (punctum) narrows or becomes blocked, leading to excessive tearing and eye irritation. Symptoms include tear overflow, increased eye moisture, and redness or irritation from constant tissue use. Initial management may involve punctal dilation for diagnostic purposes, but most patients require surgery to create an adequate opening, maintain punctal position, improve tear drainage, and preserve lacrimal pump function.
