Xanthelasma
What are xanthelasmas?
Xanthelasma is a benign eyelid formation that results from the local deposition of lipoproteins in the inner layer of the skin (dermis). It is usually located in the skin of the medial angle of the upper and lower eyelids in the form of yellowish white sharply limited plaques and impairs the aesthetic appearance of the face. They are removed surgically .
Are xanthelasmas dangerous for the eye?
Xanthelasma by itself does not create an eye hazard, but it may indicate a possible liver or pancreatic function problems and further treatment is recommended.
What are the symptoms of xanthelasm?
These phenomena most commonly occur in the form of yellowish-white sharply circumscribed plaques located in the inner corner of the eyelids. The xanthelasmas are soft to the touch and can appear on all four eyelids. They can also grow over time and merge with one another. They do not interfere with eyelid function unless ptosis (upper eyelid lowering) occurs.
Risk factors
The xanthelasms usually apear because of high levels of lipids in the blood, but can also occur in diabetes, liver disease and genetics.
M / F incidence, age group
It occurs more frequently in postmenopausal women.
Is there a natural cure for xanthelasm?
There is no natural cure; they always need to be surgically removed. A blood count should be taken as a precautionary measure to determine if the patient has high blood lipids and warn the patient to regulate it so that there is less chance of recurrence in the future.
Xanthelasma – surgery
Before surgery
A detailed specialist examination on the slit lamp should be performed prior to the surgery itself.
It is explained to the patient what the procedure will look like and the necessary premedication is given.
When entering the operating theatre, the patient receives a sterile cap and sockets.
The course of the surgery
In the operating room, the patient is comfortably placed on a bed. Nurses disinfect skin around the eyes and place a sterile drape over the patient.
The surgery takes 15-30 minutes, depending on the size and amount of the lesion to be removed. The patient lies on the bed and is constantly awake and communicates with the surgeon. The skin is anesthetized so that the procedure is completely painless and comfortable. Because the surgery is elegant and quick, most patients are surprised that everything went so quickly and easily and that all the fear people usually have before the surgery was unfounded.
After the surgery
After the surgery, sterile eyepatch is placed over the eye. After the dismissal from the clinic, the patient receives post-operative therapy consisting of drops and / or ointments and instructions to be followed. Three hours after the procedure, the eyepatch can be removed. The day after patient comes for a checkup and until then adverse microclimatic conditions (wind, dust, smoke) should be avoided. Another control is required in 7-10 days to remove the stitches (if any) and afterwards as needed.
ECTROPION AND ENTROPION SURGERY
Ectropion
is an outward twist of the eyelid so that the conjunctiva is facing outwards and exposed to external influences, which can cause drying and redness of the eye. If it engages the lower eyelid, it can prevent the tears from draining, so permanently wiping it further aggravates the disease.
More commonly present on the lower eyelid, it can be congenital and acquired. Congenital ectropium is rare and is most commonly associated with other anomalies. Acquired ectropium may be:
Senile ectropion is caused by the loss of tarsus and the ligament elasticity due to the aging process.
Mechanical ectropy is caused by lesion that mechanically everts the eyelid.
Cycatricial ectropium is the result of scarring of the skin after the injury or inflammation.
Paralytic ectropy occurs after paresis of the facial nerve leading to loss of function of m.orbicularis oculi and inability to close the eye (lagophtalmus).
Neutral and antibiotic drops and ointments are used to temporarily relieve the symptoms, but the definitive cure is achieved by surgery to shorten the eyelid.
Entropion
is the inward eyelid eversion, so that the eyelashes come in contact with the cornea and the conjunctiva, giving the feeling of a foreign body in the eye.
Congenital entropion occurs as a result of underdeveloped or deficient tarsus and hypertrophic marginal part of the orbicular muscle leading to loss of eyelid stability.
Acquired entropy can be:
Involuntive entropy occurs most commonly on the lower eyelid after 60 years of age. It is caused by “floppy” eyelid structures due to the aging process.
Mechanical entropion usually occurs on the upper eyelid due to mechanical pressure from excess skin, swelling of tissue, or tumors near the eyelid.
Cycatricial entropion occurs as a result of scarring of the eyelid due to inflammation, injury or surgery.
Spastic entropy is caused by the reflex spasm of M. orbicularis oculi due to irritation or inflammation of the eye.
Neutral and antibiotic drops and ointments are given to relieve the symptoms temporarily but the definitive cure can only be achieved by eyelid surgery.
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