Eyelid problems:

Often Overlooked: Your Eyelids

Lumps, Redness, and Other Problems

by Orlin Sorensen

Your eyelids are more than just a place to decorate with colorful shadow or to half-close while you're flirting with someone across a crowded room. Though we look at them in the mirror daily, our eyelids are often overlooked. They might not be the most glamorous part of the body, but they perform a myriad of important functions and, as well, are subject to numerous types of injuries - so this month, let's look at lids.

Your eyelids serve to protect the delicate structures of your eye from injury, light and environmental irritants such as dust or smoke. They are made up of an outer layer of skin, a middle layer of muscle and tissue that gives them form, and an inner layer of moist conjunctival tissue. Did you know that the skin of the eyelids is among the thinnest anywhere on the body?

Your eyelids also maintain a smooth corneal surface by spreading tears evenly over the eye. When you blink, your eyelids close over the eye many times per minute, which aids the flow of tears across the eye, and you can close your lids voluntarily to form an added protective layer at times of potential trauma. The eyelids are closed over the eye at night to help reduce the evaporation of tears.

The skin of the eyelids joins the conjunctiva at the lid edges, which also contain glands for the tear film and your eyelashes. At the inner part (by your nose) of the upper and lower lid margins there are small ducts, which drain away excess tears into the back of the nose.

The lids are held close to the eye by muscles and tissue of the upper and lower eyelids. Their springy quality helps us blink fully, help tears to drain adequately, and maintains the youthful appearance of our eyes. The reason our eyes get "baggy" as we age is that the middle layer of muscle and tissue loses its elastic quality and starts to droop (just like the rest of our body!). When the skin on the upper lids becomes looser with time, it can hang down over the eyes, which not only makes us feel or look older than we are, but may also interfere with our vision. This condition is known as dermatochalasis and can be corrected with surgery.

Excess fat may collect in the lower eyelids. While we all nat-urally have fat pockets in the lower lids, pockets can accumulate too much fat, and the fat can herniate forward, creating puffy or baggy eyes. The muscles and tissues around the eyelid may become weaker, resulting in the eyelid folding inwards (entropion) or drooping outwards (ectropion). This is particularly common in older people; the treatment for both problems is a small operation aimed at restoring the eyelid to its proper position.

There are many other causes of "droopy" eyelid, including diabetes, Bell's palsy, and adrenal insufficiency, so check with your doctor if you note this happening to you. In addition, you may notice you have reddish eyelids. This symptom may be caused by something as common as a sty or rosacea (a skin condition common to women that manifests as reddness around the nose, cheeks, or forehead, but that may affect the eyes as well). Or it may indicate chalazion, a lump in the eyelid that is caused by inflammation of a gland within the skin. Typically, this lump grows over days or weeks and is occasionally red, warm, or painful.

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