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Upper lid drooping can block the upper field of vision, cause patients to feel sleepy when they are not tired, and even lead to headaches from constantly trying to raise the lids or bumping into things. The most common goals of surgery to address drooping lids are elevation of the upper eyelid to improve the field of vision, permit full visual development in children, or to establish more symmetry with the opposite upper eyelid.

Drooping lids can result from developing excess skin in the lid that overhangs the eyelid margin, a condition called dermatochalasis. Dermatochalasis may be treated with a blepharoplasty surgery, which involves removing excess skin using an incision placed in the natural eyelid crease. 

Eyelid ptosis is another form of drooping lid that results from a weakening or stretching of the muscle that lifts the eyelid upward. Eyelid ptosis repair usually involves tightening the weak / loose muscle either through an incision in the eyelid skin or in the back side of the eyelid. For severe cases, the eyelid needs to be lifted using other techniques that use the forehead lifting muscle for extra strength. 

Some patients are born with eyelid ptosis, a condition known as congenital ptosis. This is also treated surgically. The specific operation used to repair this condition is chosen based on the severity of the ptosis and the strength of the eyelid lifting muscle.

It is important to realize that a perfect eyelid position and function may be impossible to achieve. Results also do not last forever. 

When droopy eyebrows are present, a procedure to elevate the brows may be appropriate. Correction of mild to moderate brow ptosis may be accomplished through the same incision as an upper eyelid blepharoplasty. When the droopy eyelids are more severe, surgery directly above the brow, in the forehead creases, or at or behind the hairline may be indicated.

Treatment for this condition is directed at the underlying cause. Most commonly, patients produce too much water as a result of a dry eye condition. This is usually treated by the patient’s primary eye care provider with over-the-counter or prescription eye drops, hot compresses, eyelid cleansing, and/or oral medications. Some patients produce too many tears because of certain neurological conditions. Other patients have watery eyes because their natural tear drainage system stops moving tears away from the eye surface. This can be a very complex problem resulting from one or a number of eyelid or tear drain plumbing issues. Some of these can be addressed medically, while others may also require surgery. 

It is important to understand that not every patient who has excessively watery eyes will be treatable. In other words, despite available treatments, some patients continue to water indefinitely.

Surgical removal is the most effective treatment for periocular skin cancers. There are two very important principles in treating skin cancers — complete removal and reconstruction. Complete removal of the skin cancer is necessary to reduce the chance of recurrence. Reconstruction of the resulting defect is tailored to preserve eyelid function, protect the eye, and provide a satisfactory cosmetic appearance.

Surgery may not be an option or desirable for every patient. Other treatments may be available, depending on the type of skin cancer and location.

Thyroid eye disease is an autoimmune condition that affects the tissues of the eye and the eye socket. It can occur in patients with overactive, underactive, and even normally-functioning thyroid glands. Patients develop a range of problems, including pain around the eyes, inflammation of the eye sockets, bulging of the eyes, double vision, and swelling or retraction of the eyelids. Because of the complexity of this condition, the eye plastic surgeon will often team up with an endocrinologist and other ophthalmic surgeons to help treat the problems.

A variety of treatment options exist and depend on the type of tumor. Some tumors require monitoring while others need interventional treatment. This may include surgical excision, radiation, chemotherapy, or immunotherapy. In some instances, other specialties including neurosurgery, otolaryngology, or radiation oncology may be involved.

Trauma can take many forms, from simple abrasions on the eyelids to complex fractures of the facial bones. Treatment depends on the nature of the injury.