At the Center for Sight, Gregory T. Hofeldt, M.D., has completed a fellowship in oculoplastic surgery. He is highly trained and experienced as both an eye and plastic surgeon, specifically focusing on the eyes and surrounding structures. He provides comprehensive evaluation and treatment for disorders of the eyelids and eye sockets, including conditions such as entropion and ectropion (abnormal eyelid positioning), dermatochalasis (droopy eyelids), ptosis, inflammation, and other issues related to the bony orbit, as well as evaluations and treatments for the tear drainage system.
Eyelid Positioning Problems
Eyelid positioning problems such as entropion, ectropion, and ptosis are specialized concerns addressed by Dr. Gregory Hofeldt at the Center for Sight in Fall River, where he provides thorough consultations, examinations, diagnoses, and treatments.
Entropion
Entropion is a condition characterized by the inward turning of the eyelid—typically the lower eyelid—causing eyelashes to rub against the cornea. This condition may be congenital or acquired. In infants, it rarely causes issues as the soft lashes do not damage the cornea. In older adults, entropion is usually due to muscle spasms and weakening, leading to the eyelid turning inward. Symptoms include excessive tearing, redness, eye irritation, discomfort, and potential vision decrease if the cornea is damaged.
Ectropion
Ectropion is identified by the outward turning of the lower eyelid, exposing its inner surface. This condition typically arises from aging and the weakening of connective tissue, causing the eyelid to sag. Other causes include contraction of scar tissue from burns, facial palsy, or congenital defects, such as in children with Down Syndrome. Ectropion can disturb tear distribution on the cornea’s surface, leading to dry, painful eyes, chronic conjunctivitis, excessive tearing, and corneal inflammation.
Ptosis
Ptosis, commonly known as droopy eyelid, results from weakness in the muscles responsible for raising the eyelid, nerve damage controlling these muscles, or sagging skin tone. It may occur due to aging, congenital abnormalities, or health issues like diabetes or neurological conditions. Patients with ptosis may experience one or both eyelids drooping, significantly affecting their vision.
Blepharoplasty Eyelid Surgery or “Eyelifts”
The areas around your eyes and forehead play a crucial role in your appearance and often show the earliest signs of aging. Some may notice changes as early as their twenties or thirties, leading to a tired or older appearance. In contrast, well-defined, crease-free eyes can convey a more youthful, rested look. Many individuals seek both non-surgical and surgical treatments to counteract facial aging.
Upper Eyelid Blepharoplasty
Upper eyelid blepharoplasty improves two aspects of aging in the upper eyelid area: correcting excess skin, often referred to as “hooding,” and addressing puffiness from fat herniation near the eyelid. It is essential to note that upper blepharoplasty does not resolve crow’s feet, dark circles under the eyes, or lift sagging eyebrows.
Lower Eyelid Blepharoplasty
Lower eyelid blepharoplasty enhances the appearance of the lower eyelids, specifically from the lower eyelash line to the bony rim of the eye socket. If fat herniation is present, Dr. Hofeldt can utilize two surgical approaches. The more common method employs a discreet incision just beneath the lash line, while the alternative involves accessing fat pockets through an incision in the lower eyelid’s inner lining.
For removing excess skin, an external approach is required. This procedure is long-lasting, typically not needing repetition. You may benefit from eyelid surgery if you experience:
Eyelid Skin Cancers
Eyelid skin cancers are increasingly common due to active outdoor lifestyles and longer lifespans. Growths around the eyelids and face are prevalent. During your regular eye exam at Center for Sight in Fall River, we carefully assess the skin around your eyes, as your eye health and vision are our top priorities. Fortunately, while growths on the eyelids and surrounding skin are common, most lesions are benign and can be easily removed in-office. Our method of addressing these growths mirrors standard practices for skin growths on other body areas.
Changes in size, color, or appearance of growths on your eyelids or face should be reported to your eye doctor.
Sometimes, a biopsy may be necessary. This quick, straightforward procedure is generally not uncomfortable. Dr. Hofeldt has extensive experience in evaluating and treating all forms of abnormal skin growths on the eyelids. If a biopsy indicates a malignant or cancerous growth, Dr. Hofeldt will thoroughly discuss your treatment options to help you make informed decisions about your care.
Common malignant growths of the eyelid and face that we monitor include:
Basal Cell Carcinoma
Basal cell carcinoma is the most common malignant growth of the eyelid, typically growing slowly and present for several months before detection. This type of cancer rarely spreads but requires removal. Dr. Hofeldt will evaluate any abnormal growths on the eyelids and may recommend an in-office biopsy. If malignant, further management could involve simple procedures or extensive removal and reconstruction under anesthesia, using stitches, skin grafts, or flaps.
Once completely removed, it is essential to monitor you over the following years. While recurrence is unlikely, individuals who have had basal cell carcinoma are at greater risk for developing additional instances in the future. Most patients fare very well, with minimal or no residual cosmetic deformities post-resection and reconstruction.
Squamous Cell Carcinoma
Squamous cell carcinoma is also a slow-growing eyelid or skin cancer, but it has a greater potential to invade surrounding tissues and metastasize. This type can also travel along nerve roots, potentially causing pain. Fortunately, it is less common than basal cell carcinoma. Treatment typically is similar to that of basal cell carcinoma.
Sebaceous Cell Adenocarcinoma
Sebaceous cell adenocarcinoma is rare and can mimic various benign eyelid issues, leading to misdiagnosis or delayed diagnosis. This cancer poses a significant risk due to its potential to spread. Even with adequate biopsy specimens, diagnosis can be challenging.
Melanoma
An abnormal skin coloration on the eyelid may indicate melanoma or a related condition. While eyelid melanomas are rare, any pigmented lesion around the eyelid requires attention. Guidelines for monitoring abnormal skin color on the eyelids are similar to those for pigmented lesions or moles on other body areas.
Changes in color, size, or behavior warrant evaluation and possible biopsy.
Please inform your Center for Sight eye doctor about any concerns regarding eyelid lesions, particularly if they are new or have changed in any significant way.
If you or someone you know is concerned about eyelid or facial skin cancer, please call Center for Sight in Fall River, Massachusetts, at 508-730-2020 to schedule a consultation.
