It is common for the lid tissues to become lax and droop down with age. This can be a cosmetic problem, but it can also be a "functional" problem when overhanging lid tissues obstruct your upper field of view, cause eyelashes to hang down into your gaze, and cause eye fatigue from the added effort needed to elevate these tissues by using your brow muscles.

Medicare and most insurance companies do cover eyelid surgery when it is functionally disturbing. For example, Medicare allows coverage when overhanging tissue blocks 12 degrees of the upper field of view or hangs down to within 2.5 millimeters of your mid-pupil.

Upper lid blepharoplasty is a procedure in which excess skin, muscle, and fatty tissues are removed from the upper lid under local anesthesia, eliminating loose, overhanging lid tissues. This procedure is performed right in the office of Advanced Eye Care, eliminating the extra expense of hospital or surgery center fees. Stitches are placed in the skin for one week, and then removed. Some bruising and swelling is common for about one or two weeks.

Ptosis is a separate condition in which the eyelid margin itself falls lower. The levator muscle, which usually raises the lid, loses its hold on the lid, allowing it to fall. Ptosis repair involves tightening this muscle deep in the upper lid to better raise the lid. This can be combined with blepharoplasty if both problems co-exist.

The lower lids can also become lax, allowing them either to turn inward, causing the lashes to rub against the eye (entropion) or to rotate away from the eyeball causing tears to run over the lid margin (ectropion). Both of these conditions are functional problems and covered by most major insurance companies, including Medicare.

Skin cancers are another common eyelid problem, especially in the sunny Florida climate. Small cancers can be readily removed and closed with stitches, but larger ones may require a piece of skin from the upper lid or behind the ear to close the defect.

These procedures and others are available at Advanced Eye Care and are usually performed right in the office. Dr. Ben Hasty has two decades of experience in performing and teaching eyelid surgeries.